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� � <br /> PERMIT APPLICATION , <br /> BUILDING/MEGHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SI�EADDRESS: PROPERTYTA%tt P RMIT/ <br /> 3�� e�a���+ v- � a <br /> LEGAL for new construction. Short PlaUsubGivision Lot No._ (attach copy ol long legal Cescriphon) <br /> OWNER NO,eT// SDdN N Phone/E-mait <br /> nad�ess f0- //p�� y ,(/ C C�ty/Slale/Zip Q L ✓u ��i1 <br /> APPLICAKT:_Owner Owner'sAgent _ Conuaclor Co�itractoYSAgenl TPnanllmunpo.,e��ienaro�cv�sentlromineowne�mcowoniemespace� <br /> CONTRACTOR 6r C� State Lic.f�G R a ty Bus. Lic. # � A S <br /> Aaaress PhonelEmait <br /> TENANT BUSINESS NAME CON1'ACT FOR PERMIT <br /> �1¢wE Ss.r��r' <br /> PhonelE�mail AL1/ ,CO <br /> BUILDING PERMIT APPLIGATION CONTRACT PRICE OF WORK <br /> Ezisting Use of Budding_ HEAT SOURCE: <br /> Proposed Use Of Building _ Gas_ Eleclric_ Ot�er_ <br /> Budding type' _Single family _Duplex_Townhouse _Mulli-Famity _Commercial ✓ <br /> Type of pro�ecf. New Addnion Remotiel P,epa�r_T.I.__Sign_Sprinkler l�Demolition Change of Use <br /> DESCRIPTION OF WORK(addinona�space prowded on me back/ 3 Z�c7 <br /> �Er'p�srsu�✓ �F Ms.rcd I�SE 8�a�-��h M�d �� •rc_ o,� <br /> AsA�+'�+sr Pac%.r�r ,�het.� - Wil1 ��s-fo�e s+�e_ w/ �+v�(r�ecl G's <br /> n �ssu . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: _New_Addn _Atteratlon_Repair Type ol Project: _New_Addn _Alteration_Repair <br /> Show Number(N)ol/ixlures Show Number(N)o//ixNres <br /> A/C—air handling unds _ Toilet <br /> Forcetl air s stems Balhtub <br /> � Gas piping Lavalory(wash basin) <br /> lNaler healer Shower <br /> � Gas fireplace � Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> � Clolhes dryer Clolhes washer <br /> � Range hood Waler healer <br /> [zhaust fan Sink(service/bar/mop�etc.) <br /> Heat pump Backflow preven�er <br /> Uml heater Urinal <br /> Boiler � Drmkm Founlain <br /> Refr�qcration Floor drain <br /> Woodslove C�ease trap <br /> Guchng � !.00f dreins <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM O�her: <br /> Number ol Head> � Other <br /> I�ere0y cMdy Ihal I�ave rea0 an0 erammeA I�is applKatron and Ynaw Ihe same ta be Ime and wrre<t.A1 pio�srons ollaws enE orGmances 9ove��ing t�ir IYFe ol work wi1 be complieE <br /> wB�wheiher 5peciGeE herein o�not.T�e granbnp ol e permil Ooes nol presume lo grve aul�or�y to vio!ale or cancei I�e pmvis�on ol any atner stele or lacai law regulating conslrvtl�on <br /> Tnat I am em�onie0 Uy I�e owner ol t�is propeny to petlorm t�e work br.Mic�apD�iw�ron is ma0e anU i comply wii�the State Comrac�ms Law 18.77 RCW anE]96 i00A WAC. I/ <br /> /� � Z <br /> Ov erlAuthorized Agen1 Signa� lD/ �/ Dale (Revised J/2013J <br />