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• <br />• <br />PERMlT APPL��CAT��}N <br />BUI�t�1NGiMECHANICIa►L/PLUMBINGIS��N/SP�tINKLER�DEMOLITION <br />CtTY OF EVERETT PEF�Mii' SERVIGES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-25�-�857 www.everettwa.org <br />Tnx n <br />EGAL for new cc�nstructi�n: Short PtaUsubdivisian �ot No. (attach capy of long iegal descriptie�rs) <br />�WNER `t �. � ..C_. t� PhoneiE-mait p�t ,,��" • � c� • � ��% <br />ddress Qti.— City/SlateiZrp <br />PPLICANT: � O�wier _ pvmer's Age�t Contractor � Cantractor's Agent _ Tenant tn,�sicr�,r��e a iene� u< <.o�5��t o-on; c�,e a+F,�,a< <a ca .� m� �U <br />ONTRAGTOR j,�y�,,,y�,,,d,.r� St2te Lic. # � Gity B�is. Lic. C? �� d <br />ddress {)` .�'^ (,,,(, � �� Phone/Emaii �� • � � � ' ��S <br />ENANT BUSINESS NAME CONTACT FOR PERMIT p,,,� m� � <br />BUILDIN� RERMIT APRE�IGATidN <br />Exisiing Use of 8uiiding � <br />Proposed Us� af Building <br />PRIGE QF WC1RK <br />Buiiding (ype: � Sing{e Family _ Dupi�x _Townhouse � M�Ifi-Fat'r�Uy _ Cammer��at <br />Type of pro}ect: New Addition F2emodel F2epair T.i. Siqn 5prinkEei <br />I�ESGRtPT QN OF WORK (eddi�ionat sp ce provided on tbe ack): <br />�� ��, +�71. t' ,c... �t... � i �;—� �� i� � �. <br />MECHANICAL PERMIT APPLICATION <br />of Project. �New _Addn ,_,_, ►teratian _Repair <br />ShowNumber # oftixtures <br />AIC -- air handlin units <br />j Farced air sys#ems <br />Gas �ipinq <br />! Water heater <br />' Gas fireplace <br />�� <br />3 Gas r�nae <br />Range hood <br />Exhaustfan <br />Neat pump <br />Unit heater <br />Bailer <br />Refric�eratEoi <br />W ondstove <br />r Y1.� t..-�e�.. <br />HEAT S�UF <br />L khP,t <br />Cha�oe of Use <br />PLUMBING PERMIT APPLICATION <br />7ype of Project: ^New _Addn �Aite�ation _Repair <br />Show 1Vumbur (#) af fixtures <br />E Toilet <br />Oishwasher <br />Ckothes wash <br />�/ater heater <br />Sink (servicel <br />Backflow pr�e� <br />Onnking F� <br />Floqr drain <br />Other Medical Gas <br />SPRiNKLER l SUPPRESSft�N SY�TEM � t�ther: � <br />� Number of Neads <br />� Other: <br />I hereby cenih,r that t have reatl and exam,med Qi�s epp6caHon aad know �ha same to be Irue and cortect. AN. prov�5ions of laws and ard�nanst�s governing th�s Cype of urork wdl be ccm� <br />� h whether sper.ified herein or not Thr., {�ran6ng nt a permit dnes nol prc,ume ta c�lve authanty to violate nr cancul the prov�ion of any other state c�r locai law rey�latiny ccrostruction <br />Trin i�Jrn aufnnrized by the nwn r of lhis property 10 parform ihe work for whi applicaf n as �nadF and 1�pmpty wdh ihe Stale Cor�lractors Law 18.27 RCW and 2�36.2a0A WAC. <br />� !1 � � J � <br />neriAuthorized Agenl Signafure Date fRevrsed 9/2014} <br />��� <br />� <br />