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1 ' <br /> PERMIT A�PLICATION <br /> BUlLDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> �- <br /> CITY OF E\�ERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRE99: PROPEnTY 7AX p MIT� <br /> � ►�c'r,�l 1�A 820/ ��lD 5 30 . n I r o - G� <br /> LEGAI lor naw conelruclion: Shoh PleVeubdiviclon Lo�No��i(altech copy ol lonp lepel deacripllon) <br /> OWNER LC7/ Phore/E-mail r- - � ✓ <br /> Addreae L /� ��,�' Ci�y/Slate/Zip j�e q 2 � <br /> CONTRACTOR L&I Lic.# <br /> Addreae Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE•mell <br /> BUfLDING PERMIT APPLICATION CON�RACT PRICE OF WORK <br /> Exisling Usa ol8uilding f HcAT SOURCE: <br /> Proposed Use of Quilding - Gae Ekctdc Otner <br /> Building lype: �Single Family _Duplex_Townhouse _Multi-Family _Commerciel <br /> Type ol projecl: _New _Addilion _Remodel _Repeir_T.I._Sign_Sprinkler�Damolition_Change of Use� <br /> DeaCflp�ion ot Wofk(eddifional space provitled on the backJ: �CYYIOII�I G I� � �A�I�� u/�� ��mP���°" <br /> c'oN�rl�l-f)��r Or Y��i� �lOm�. <br /> Have you etarted warking wllhout a pertnll7 _YES _�10 <br /> MECHANICAL PERMIT Ap�'LIC/DTION PLUM8ING PERMIT APPLICATION <br /> TypealProjeet: _New_Addn _Alterellon_Repelr TypeofProJect: _New_Addn _Allenllon_Rep�lr <br /> Show Number(N)ol Ilrturos Show Number(N)ol/Ixtuns <br /> A/C—airhandlin uNls Toilet <br /> Forced eir s s�ems Bath�ub <br /> Gas i in Laveto wash besin <br /> Water heater Shower <br /> Ges Gre laca Y.itchen sink 8 dis osal <br /> Gas ran e Di:•hwasher <br /> Clolhes d er Clothes washar <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/barlmo letc.) <br /> Heat ump Backllow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Relri eration Floor drain <br /> Woodstove Grease�re <br /> Ductin Roof draina <br /> Olher Medical Gea <br /> SPRINKLER / SUPPRESSION SYSTEM other. <br /> Number ol Heads Other: �I <br /> I�eroby cehily Ihal I have reatl xnd ezamined Ihb epplicatlon end know�he eeme to be Irue and corted.Ali provislona ol lewa end ordinence�poveminp <br /> ihis lype ol work will be complied with whethe�apeclfied Rereln or nol.The Brenll�p ol a permit does not preauma lo piva aulhorl�y to vlola�e or cancel � <br /> Ihr provision ol eny ol�er slete o�locel lew repulatlnp conaVuctlon or the peAormance ol cons�nictlon.Thet I em eulharized by Ihe ovmer ol lhle(.roperry <br /> 'u peAorm Ihe woik lor which epplicallon is mede and I comply with Ihe Slale Con�rectore Law 18.Y7 RCW end 298.200 WAC <br /> �i1 ,� � I <br /> OwnerlAuthoAzed Apanl Sipn� Dale (RevisedT/d0f f) i <br />