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PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810-FAX 425-257-8857-www.everettwa.org y <br /> APPLICATIONS ARE ACCEPTED fROM 8 AM TO 1 PM `I4 <br /> SITEADDRES9: VROVERiYTA%N P RMIT� <br /> 50� ►1�. �. ao i o0 4o u c I —O 5 <br /> LEGAL far new conetructbn: S�ort PlaVauD0lvldon �i�RCz. ��RZS Lot No._ (Bltach�opy ol lonq leqal defulD�lon) <br /> OWNER 1�( ��CUCK PhonelE�mall �s-�ta- ba <br /> aares. oZ0 alk� D�= ciy�siate,z�v E.le�"e� Wa ab20 ''a <br /> CONTMCTOR G�c n L 8 I Lic.M <br /> tlCreef Pfwne/Email <br /> TE TB N E O T CT R IT �( N�G <br /> 'i eo - s�t — � �se� <br /> PIwrNE�mall A} Q� • � <br /> SUILDINO PERMIT AP�LICATION CONTRACT PPICF.OF WORK _ <br /> Existing Use o18ullding 1 1 1 u4LE t Ly' HEAT SOURCE: <br /> Proposed Uae of Building RK�AC�T�� 5(�►�i(�i FAA4�Gl� Ge� Electric O�har <br /> Building type: �,Single Family _Duplex_Tavnhouse _Multl-Femily _Commercial <br /> Type ot project: _New _Addilion �Remodel �Repeir_T.I._Sign_Sprinkler,�Demoiitlon_Chenge of U�e '• �J �� <br /> Desc�Ip�IOnOfWork(atldifbnalspacapoNCedonthebeckJ: OG�� Mai� �'�-. �ei(yt�' ��y�L. � p�hiNt �1�'���'1 <br /> RoM..c41 FiFsc.u.•�t: C��•4l�veo�.) s1.oQ;`o�N.1�C11Beclres►. � -� yr�wo�t Su�roow <br /> Have you�laAed working wilhout a permit9 _YES �NO <br /> MECNANICAL PERMIT APPLICATION PLUMSING PERMIT Ar�LICATION <br /> Typa ol ProJ�cL• _N�w�,{,_AdAn _Attantion_R�palr Typ�ul Pro��cL• _N�w '�Addn _Alt�ntlon_R�ptlr <br /> Show NumEer )01 flifuni Show Numb�r(� ol llrfuna <br /> AIC—alrhandlin �. ita Tollet <br /> i Forced eir s slems / Balhtub <br /> Gaa I In Lavalo wash basin <br /> Watar heater ' Shower <br /> � Gas fire lace Kitchen aink 8 tlis osel <br /> Gas ran e Dishweaher <br /> � Clolhes d er Cblhes wafher <br /> Ran e hood ter <br /> � Exheusl fan � Slnk eervicelbarlmo lelc. <br /> Heat um BackOow reventer <br /> Unit hoater Urinel <br /> Boiler Drinkln Fountain <br /> � Refri eralion Floordraln <br /> Woodstova Greaee Iro <br /> Duetin Rool drai�s <br /> Other Medical Gae <br /> SPRINKLlR I SUPPRlSSION SYSTEM otner: <br /> Numter ol Heads Othar: <br /> 1 nereoy certiry tnat i havo�ead enC exeminea inie eppii�uon and xnow tna same�o be true antl wrrecl.An provia�on�ol law�ana ominar�wa povemirp <br /> inis lype ol work xnl be wmplied vnlh w�ether epecifietl�erein or nol.The prenllnp of a permd Coe�not prasume to plva eullwnty lo vlolate or cancel i <br /> Ihe provlsion o1 any olner elate or lowl law repulalinB��alruction or Iha pedormance ol comlruhlon.iTal I em autlwrizad by I�e owner o11hB properry � <br /> to peAor�lhe wo�k br which aDD�ation b made and I wmpN w��h�he Stale Controctae Law 1E.Y7 RCW enA 298 700 WAC i <br /> �.. �,I/� / ' <br /> . .�.,-:/" � _ D9 / e �/� �r+aNseazzo��J �/ �� <br /> OwnorlAuthod¢atl Agen1 Slgnature / � ��. i <br />