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PERMIT APPLiCATION <br /> BUILDING/fVIECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SER':ICES �/��/// <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8657—vwvw.everettwa.org <br /> APPLiCATIONS ARE ACCEPTED FROM B AM TO 1 PM 3 (J L " <br /> SITEADpR PROPERTYTA%N PE J O <br /> , o �i�4if/� � G � � �. ' � vimc� v>3 <br /> LE6AL lar new conelruction: Short?IeVeubdivislon Lo�No._ (etlach copy ol lonp la <br /> OWNER PhonelE�meil <br /> Adamse CltylSlete2ip �-! �� � <br /> CONTRACTOR / � � � � G/!s L 8 I Lic.# O� �j�(, �OU <br /> �ti��� <br /> Address ' (� [J .� .n � � � �C�d a� hona/Emell y L '- f�G j" S'Y <br /> TENAN7 BUSINESS NAME CONTACT FOR PERMIT j i//J�. `jjjJ- <br /> � �� f'�(� v P�onelE•mell ��z " � � y� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �. Y�� <br /> Existing Use of Builtling � •c. NEAT SOURCE: <br /> Proposed Use of Building <br /> / � � � ` Gas Electrlc Olher <br /> Building type: _Single Femily __Duplez_Townhouse _Mulli-Femily �Commerciel <br /> Type of projecC _New _Addition _Remadel _Repelr_T.I.�Sign_Sprinkler_Demutition_Chenge ol Use <br /> DesCription of Work(addRionel space providad on fhe bech): <br /> Have you staAed working wlthout e permlt9 _YE£ �NO <br /> MECMANICAL PERMIT APPLICATION PLUMBIN�i PERMIY APPLICATION <br /> Type ol ProJecl: _Now_Addn _Alteration_Repalr Type ol ProJ�ct: _New_Addn _Altenllon_Repdr <br /> Show Number(M)ol/lxfures Show Numbar(MJ o/Ilxfuros <br /> A/C—eir handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Levato wash basin <br /> Waler healer Shower <br /> Gas fire lace � Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er C�othes washer <br /> Ran e hood Water heater <br /> EMhaus�lan _ Sink(service/bar/mo /e�c.) <br /> Heal um BackOow preventer <br /> Unit healer Urinal <br /> Builer Drinking Fountein <br /> Refri eration Floor drain <br /> Woodstove Greese lra <br /> �uctin Roof drains <br /> Olher Medicai Gas <br /> SPRINKLER / SUPPRE3810N 8YSTEM j Olher: /��v�� _ <br /> � <br /> Number ol Heads Other: <br /> I hereby cerlity Ihal 1 heve reed enA azamined�hla applicetlon end know Iha aame to be irue end co�racl.All provlsiona ol laws and ordinancee poveming <br /> t�is type ol work will be complieC wilh whelhrr specified herein ur not The greming ol e permll doen not presume to qive euthodty lo vlolala or cancol <br /> Ihe provision ol any olher sta�e or local lew regule!ing consiruction or ihe pedalmance ol conntruclion.Thal I em aulhorized 6y the owner ol lhle propeRy <br /> to De�orm Ihe work for which epplicatlon It made and I compry wilh the Stale Conlracbrs Law 18 27 RCW anJ 2B8T00 WAC <br /> '/�/� ��J��t�/ ` oate (ReviaedYlOit) <br /> OwnulAWhorizad Aganl SlpnaWn <br />