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rGRtY11 1 t-�r r �...�vr� � �v�. <br />BUILDING/MEC�NICAL/PLUMBINGISIGN/�RiNKLER/DEMOLITION <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-2�7-8857 www.everettwa.org <br />ITE ADDRESS: � � �, `l � , DO�� �� Do%�d UOl� I j'h � �C�?-' <br />� <br />� L,� <br />�AL for new construction: Short PlaVsubdivision ' Lot No.• (attach copy of long legal description) <br />�NER �i����� lrU�f��� fIL�TiTd%Z Phone/E-mail / G ���U , � � � <br />�ress f � �DX ��S`�}� Ciry/State2ip �-/iE%% .i��I ��0� ' <br />PLICANT:,� Owner _ Owners Agent _ Contractor _ Contractors Agent _ Tenant �mu:� P��ae e ianer �r c«,.e�c tr�m �ne �,R,er co do woric u, a,e sPece) <br />NTRACTOR /�NOG <br />State Lic. #���la'C_��l �b � z- City Bus. Lic. # <br />Phone/Email <br />1R PERMiT ,QND� ji <br />�ic-6`i� "a(/ �/�� Phone/E-mail � � Z <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK _ <br />Existing Use of Building s/�� <br />Proposed Use of Building �/�� ' Gas <br />Buiiding type: ,_ Single Family _ Duplex Townhouse _ Multf-Family _ Commercial <br />T e of ro'ect: New Additlon Remodel Re air T.I. Si rt S rinkler [ <br />DESCR1PTlON OF WORK (additlonal space provided on the back) : <br />HEAT <br />E"-L T�F' <br />�,3 — ��� <br />�. �� <br />1RCE: <br />_ Other_ <br />Chanae of Use <br />MECHANICAL PERMIT APPLICATION � � PLUMBING PERMIT APPL1cAT�oN <br />Type of Project: _New _Addn /� Altera <br />Show Number # of Rxtures <br />AiC — air handlin� <br />Gas p�ping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryei <br />Range hood <br />Exhaust fan <br />Other <br />_Repafr I IType ot Project: _New _Addn _Alteratton _Repalr <br />Show Numbe► (#) of fixtures <br />units <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Bathtub � <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbar/mop/etc.) <br />Backflow preventer (fnside bl� <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other. <br />Other. <br />I hereby certity that i have read and examined thfs applkatbn and know tha same to be hue and correct. A11 provfsbns of laws and ordinances goveming thls type otwork wip be <br />with whether sp ' ed herein or not The granUng ot a pertnit does not presume to gNe authority to violate or cancel the provfsion ot any othar stale or bcal law regulatlng constn <br />That I em au bri d by e owner of ihis property to pertortn the work forwhlGi appNcaUon Is made and I compy with the State Contrectors Law 78.2T RCW and 298.200A WAC <br />/ 7. / , <br />/ <br />Owner/Authorized Agent Signature Date (RevJsed 4/20' <br />