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�F'ERMIT APPLICATI4N <br /> BUILDINGIMECHANI�ALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810-FAX 425-257-8857 -www.everattwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM <br /> SITEADORES : r n D0.0PEH7VTAXp PERMIT{ <br /> � 1 . 7 � ��. C-l� . � � �rf `��c'��� (� j� f[ 1 tY �L� <br /> LEGAL lor new conslructlon�. Sho�PleVsubdivielon I �� Lol No�_� (altech wpy oi long legal deacnotlon) <br /> OWNER ��-'fi��1e'�' �!'l^ Phone/E-mall l�Z��-.3� -�/�� .�1 'd � <br /> Addre65 Z/ c , �� ��� cnyisia�erz�P �Y'e'Y ll� 9`•3�f'1 � <br /> CONTRACTOR U7Y1 � L 81 Lic # � <br /> AAtlresn 5 ( � _ �j �j(�V . PhonelEmell <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �,,,�-��r- '"L._,�� <br /> �.r�� <br /> PhonelE-meil �727���]-� �3 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_��I3�Z <br /> Ezisting Use of Building HEAT SOURCE�. <br /> Proposed Use of 8uilding Z �� ✓� ' Y�� l°• Gas Eieadc Other <br /> Building rype�. �Single Family _Dup ez_Townhouse _Multi-Famlly _Commerciai <br /> Type of projed. ✓ New _Addltion _Remodel _Repair_T.I._Sign_Sprmkler_Demolition_Chenge ol^Use <br /> DeSCfiptlOnO�Wofk(eddiBonelSpeCBpmntleaontheDackJ: Cvn�a�-j,.�I�,.��,� `� � Z-`'�Y' �Y�)ri�� 'L'r� <br /> `�il'1,.��G' Tr,�7Yli�i� 1�Z,hlCk' 17('d, � <br /> Have you ftarted working without a permit9 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa oi ProJect: _Naw_Addn _Alteratlon_Rapalr Type of ProJect: _New_Addn _Alleratlon_Rap�ir <br /> ShowNumber N)o//7rfures ShowNumDer(M)o/llrfurse <br /> AIC-air handlin units Tcilet <br /> Forced air s stems Bathtub <br /> Gas i m Lavalo wash basin <br /> Water heater Shower <br /> Gas fire lace Kdchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes d ei Clothes washer <br /> Ran e hood Water heater <br /> Exhausl fan Sink service/barlmo /etc. <br /> Heat um Backflow reventer <br /> Und heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra � � <br /> Ductin Roof drains � <br /> Other Medical Gas <br /> 8PRINKLER I SUPPRESSION 8YSTEM Other: <br /> Number ol Heads Other: <br /> I hereby certify Ihal I heve read and eKamined this applica6on antl know Ihe aeme to De trua and wvecl.Alt provlslons ol laws end ordinances Bovaminp <br /> Ihie lype ol work will be wmplietl with whelher specifieG harein or noL The prnnlinp ol e peimil tloes nal preaume lo pive eu�hority lo violete or wncel <br /> ihe provision ol any olher slete or Iow1 law reguleting construdion or Ihe peAO/mance ol construc6on That I am eulhodzed by the owner ol ihle propeily <br /> lo pedorm Ihe w/otk Por which appllcalion is matle anA I campty wit�Ihe Slate Conlrac�ars I.aw 18.17 RCW and 296200 WAC <br /> ( � <br /> l��fi� ,'7q it'�1 il <br /> OwnulAuthodzsd Agant Slpnati e Dale (Ftevlsea Y2011) <br /> �IZ <br />