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PERMIT APPLICATION <br /> BUILDINGIMECNANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERET7 PFRP.91T SERVICES <br /> 3200 Cedar St., Everett, WA 99201 425-257-8810 FAX 425-257-8857 www.evere�a1�rg� <br /> SITF ADDRE`3S: PROPERiv TA%d PER I� n � " C� 7� -� <br /> � � �5,;�("<� �t� 1.1.1 v <br /> LhIiAL tor new conslmdion�. Short Plat/subdivision__ Lot No.__ (allach copy ol long legal descnption) <br /> OWNER ttN.�S .��t cfr� Phone/[�mail y 2�' �)Z'��6�1 <br /> Address2 �LZ F�akv CilylSlate2ip �y.i]� W✓� / �LO� <br /> APPLICANT:__Owner OwneisAgenl Conliaclor ConlracloisAger,i _Tenanl�n�s�p��:rueaiene�oimmemimmmewr�erwaow�n�nmasca:e; <br /> CONTRACTOR J[�.K�� '��`�u+'� State Lic. # Cit Bus. Lic. M _ <br /> � �' S I C L�PYJ� Gl1 N- Phone�Finail 5--3?3-Z��(7 <br /> Ad9ross 1 )� 0 /37 �a�� w r_ 1 w� <br /> TENAfv?BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/Gmail <br /> BUILDING PERMlT APPLICATION CONTRACT PRICE OF WORK ��UC) �� _ <br /> HEATSOURCE'. <br /> Exisling Use ot Ouilding__ <br /> Proposetl Use of Buildin9 _. _ Gas ElecVic Other__ <br /> Ouilding ty^A� 1� Sinale Family _ Duplez_Townhouse _Multi�Family _Commercial <br /> T pe of pro�ect: New Adddion _Remodel P.epair T.I. Sign Sprinkler Demolition Chan e of Use <br /> DES:RIPTION OF WORK(addrtionel spaceprovidodon�ne hack): <br /> �;�����11 < (� �� ��'� ft� ���'� `� ���t � i1aC� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa ol ProJocl: _Naw_Addn _Altoratlon_Ropalr Typa of ProJoct: _Now_Addn _Altorallon_Ropalr <br /> Show Number(p)ol IixNrw Show Number(H)ol Iixturee <br /> A/C-air handiir units I ToOet <br /> I Porced air s stems I Bathtub <br /> � � Lavator (wash basin) <br /> i Gas piping <br /> '� Water heater i Sho�ver <br /> Gas lireplace �� Kitchen sink&disposal <br /> ' Gas range � Dishwasher <br /> '� Clothes dryer Clo�hes washer <br /> ' R2nye hood . Water heater <br /> Exhaust lan � Sink(service�bar/mopletc) <br /> � � Backflo�v preventer <br /> j Fleat pump <br /> ; Und heater Unnal <br /> � Boder Dnnkin Fountain <br /> Relrigeralion Floor drain <br /> --- Woodstove � Grease trap <br /> �— Uvchn � Roof drains <br /> Oth�r___ Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other <br /> Number ol Heads ' Olher. <br /> It�riebycetlAylM1a111v.uredJnntletammedtlnvapP�cn:onnn4knowlheaamclo�elruenaAcanecl %IlpmvmonsollawaanEoiCinen[el9overrinpl�ntyp<olworkv.ill�ecompbeE <br /> µ�lp wM1elher speul�ea I�erein cr not Tlie grenling nl a permit Gcet not p�esuma lo qna nul�ont�lo v�olale or cancel the Drovnion ol any Ut�er slale or loGal lew requlelmq wnelmclion <br /> I I�.xl I am aul�onxe�Oy t�e ov�ner ol mp pmpiny la DeAorm t�e work lor wl�ich OpC�'�alron�f naDe ana 1 comFty wtl�Ne Slale Conlredop Uw 1E Z7 RCW BnE]98 YOOA W/C <br /> ���� 1:���� �Revised3/2013) <br /> p�f MorizodAgoniSlyna�uro � �'�� <br />