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PERMIY APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320D Cedar St., Everett,WA 98201 -425•257-8810—FAX 425-257-8857—w�wo.everettwa.org <br /> AaPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: �J � PROFERTYTAXtt �PER1MI�US -�OCJ�o <br /> <c(� J � <br /> LEGAL for new wnstruction: Shoh Plat/ ivislon LoI No._ (attach w0Y ol long legal tlesuiptlon) <br /> OWNER � 7 J PhonelE•mail - <br /> Adtlress � '� {�y � i,� 1 �Y'/Ci�YlStatGZip ` �. <br /> CONTRACTOR L&I Lic.# <br /> Address PhonclEmail <br /> TENANi B SINE S NAME �L CONTACT FOR PERMIi <br /> y,� Q � ---- yh- �.Z�-�fls7 <br /> O, / /! / �jjGL. Phone/E-mall <br /> BUILDINGPE ITAPPLICATION CON7RACTPRICEOFWORK <br /> Existing Use of Building U � � O C-L' HEAT SOURCE: <br /> Proposed Use of Building S«.�,_P�� Gas_ Eleanc_ o�hcr_ <br /> �uilding lype: _Single Family _Dupiex_Townhouse _Multi-Family �Commercial <br /> Typeofproject: _New _Addilion _Remodel _Repalr_T.I.�y5ign_Sprinkler_�emolition_Change ofUse <br /> Description of Work(atldilional space provlded an the backi: <br /> �w s1��/�;��L �� /�t�u �c� 5�f�� <br /> Have you started working v6ithout a pormil7 _YES ,�y,n0 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ype of ProJect: _New_Addn _Alteration_Repair Type of ProJect: _Nuw_Addn _Alteratlon_Repalr <br /> Show Number(p)a//i.rfures Show Num6er�ttJ a//lxtures <br /> A/C-airhandlin units Toilet <br /> � Forced air s stems Ba1hWb <br /> � Gas pipin I Lavato (wash basin) <br /> � Water heater � Shuwer <br /> � Gas lireplace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> � Clolhes dr er Cbthes washer <br /> � Range hood � Waler heater <br /> Exhausl fan Sink(servicePoarlmo letc. <br /> Heal pump � Backflow reventer <br /> � Unil healer Urinai <br /> ooiler Drinkin Fountain <br /> . Refrigeration Floor drain <br /> � Woodslove I Grease Ira <br /> � Dudin Roof drains <br /> � Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM I Other: <br /> � NumberofHeads I Other: <br /> I hereby cerlify Ihal I havn read antl ezamined lhis applicallon and knmv lhe same l0 6e true and wrrecL All provisions of laws and ordinanres goveminq <br /> this type of woik will be complied wilh whether specified herein or not.The pmntinp ot a permil does not presume lo give aulhorily lo violale cr cancel <br /> the provision of any ol�er slale or local law regulating wnstruction or ihe peAortnance ol construcllon.Thal 1 em aulhonzed by Ihe o��rner o�this property I <br /> to pedorm,tlie� rk Igrk4i (/np�pl�a' rt Is mada antl 1 comply x�th Ue State Cortractors Lew 18.27 RCVJ and 286.2��WAC <br /> �` L � .<.� / // � <br /> /;;. -�� / / 3/ <br /> owncrlAuthodzed Agent Sign ufd' � ' Dafe (Fevisetl22017) <br /> �/ Z <br />