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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetlwa.org <br /> S-1 a - I <br /> SITE ADDRESS: PROPERTY TAX It ERMIT p <br /> ' � <br /> LEGAL lor new conslmclion: Short PlaVsubdivislon. Lot No._ Wtlach copy ol long legal desaiplion) <br /> OWNER PhonclE�mail � Q <br /> Add�ess Cltyl51a�e2ip <br /> APPLICANT:�,Owner OwnersAgenl CoMrador ConlraelofsA9en1 TCpanl�muslpov�luoknerclromerlhamNee.nerlaneworM�ninosparn� <br /> CONTRACTOR Ol� � State Lic M Cil Ous. Lic. � <br /> Addresa PhonelEmail <br /> TENANT I ESS NAM CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ <br /> Existing Use of Buildmg 0.EC��PItfi n.� HEAT SOURCE: <br /> Propased Use af Bullding Gas_ Elechic__ Oiher_ <br /> Bwlding lype: �Single Family _Duplez_Townhousa __Multi•Famdy _Commercial <br /> Tyoe o(pro�ect New Addilion x Remodel Repair T.I. Sign Spnnkler_Demohhon__Change ol Use <br /> DESCRIPTION OF WORK(addrtiunai space pruv�ded on rhe bacw) <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa of Pro�oot: _New_Addn _Altontlan_Repalr Typo ol Pro�ocl: _Now_Addn _Altoratlon_Rep�ir <br /> Show Number(MJ ol qxfures Show Numbcr(M)o//ixfurof <br /> NC—air hantllin units � Todet <br /> � Forced air s slems � Uathlub <br /> Gas ipmg Lavalo wash basin) <br /> Water heater Shower <br /> Gas fire lacc Kitchen sink 8 disposal <br /> Gas ran e Disl�washer <br /> Clolhes drycr Clothes washer <br /> Ran e hood Water heatcr <br /> Erhausl lan Sink(scrvicelbarlmo /ek� <br /> Nea� ump Backflow reventer <br /> Umt hcater Urinal <br /> � Ooder Unnking Founlam _ <br /> Re(ri eration Floordrain <br /> Woodstove Grease Ira � <br /> Duclin Rool drains <br /> Other Mediwl Gas <br /> SPRINKIER I SUPPRESSION SYSTEM o�hcr. <br /> NumberolHeads Other� <br /> I�ereby cenAy tM1al I heve iaad ontl eaamine0l�b ap0�����b�ond krww t�o same lo Ea tme nMl rnnecl A4 p�ovicinns ol laws and ma�nances povemin9 tN�lypo olwod wi!I La mmdKJ <br /> vnl�whel�cr specdmd hemm o�nol The q�anlmy ol o parml Coas nol D�esuma lo grve wlnor�ly lo no�alo or wncel lha povisun ol any alher stato o�lo�l taw mgulal�nqconslmclron <br /> iliat l nm aul�otlted by 1�0 owner ol l�is qoDerty lo petloim Iha wwk lor wA¢h ap0���ahon is maao an 11 compy wiln IAe Slnle Canbaclae la��!71 NCW anE 196 YOOA WAC <br /> � i�.���.4� --�_ S-/2-ly <br /> utho AyenlSignaturo Oale (Revised7R079) <br />