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PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereil, WA 98201 - 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S 1 I <br /> SITEADDRESSL�� I ^ ,�,/ k ^ � PROPERTYTA%71 PE MIT/ <br /> lS �..c� c 1� LC - C..� <br /> IEGAL for naw conc�mction� Shon PlaVsubdivislon Lol No._ (attach copy ol fonp lepel Eetcripllon) <br /> OWNER � r� �_l S ��� - Phone/E�meil <br /> Addresa . � .� �L Clty/SlntelZip ���!r�'.L'} �/i ��O.�w� <br /> CONTRACTOR L 8 I lic. # <br /> Addrese PhonelEmall 'I,�7 – ���� �3U� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE�mall <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use o!Buiiding HEAT SOURCE: <br /> P�oposed Use of Building Gae Eladric Other <br /> Building lype: _Single Family _Duplex_Townhouse _Mulli-Family _Commercial <br /> Type ol project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinklar_Demolition_Change ol Uee <br /> DesCrip�ion ol Work�etldrtional spece p�ovided on fhe becA): <br /> c�lm�� � y �;� ��,�� ��� r�� �� �— � [ r 1�lL <br /> Heve you atarted working wilhout a pertnit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBIN6 PERMIT APPLICATION <br /> Type ol Pro�e�l: _Naw_Addn _Altanllon_Rap�lr Typs o1 Pro�eU: _Nsw_Addn _All�nllon_Rep�lr <br /> ShowNumber(N)o/Ilxturoi ShowNumb�r(N olllxfuni <br /> A/C–air hendlin umis Toilet <br /> Foiced air s stems Bethtub <br /> Gas i In Levato weeh baein <br /> Water heater Shower <br /> Gas fue lace Kitchen sink&dis osal <br /> Gasran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust tan Sink(servicelbadmo �etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boder Orinkin Fountein <br /> Refn era�ion Floor drain <br /> Woodstove Grease tra <br /> Ductin Rool dreins <br /> Other Medical Gas <br /> 8PRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certlly Ihal I havn raed end eramined ihis applicetlon end know Ihe eema lo be Inie end corrocL All pmvlsiuna ol lavn eM ordlnance�povemirq <br /> Ihi��ype ol work wlll be complietl w:lh whelhar apecified�ereln or not.The Bnminp oi e parmit doee nol pretume lo pive euttwrlty lo vblste or canul <br /> tha provislon ol eny olher etele or lacal law reguletlnB condruclion or t�e peAo�mance ol conetruction.Thel I em aulhodzed by��e ovmer ol tM�property <br /> to peAorm�he work lor which epplicatlon is meda end I comply vnlh the Slele ConMcbre Law 1827 fiCW and 288.200 WAC <br /> .��C_�Z�__._� .���5� �� <br /> Own�rlAuthodz�d Apent 91pn�lun —. TDe1e (Revi�edT/d01 f) <br /> � � ( i <br /> ��l��< <<. � �, ,-r-- <br />