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� { � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereri,WA 98201 -425-257-8810-FAX 425-257-8857-wrvw.evere a.org <br /> APPLICAT10N3 ARE ACCEPTED FROM 8 AM TO 4 PM Z / <br /> SITE ADDRESS: , r2� <br /> p11pPERTY TAX N <br /> 381� }3RDA1�A�/ S G Oo57GOo2'�oOOOL <br /> LEGAL for new conslrudion: Short PlaVsubtlivisio� Ld!b._ (atlach capY��B�'9al Eescriplionl <br /> OWHERCEP-RMS 07 ��c Prone/E�nai� 4Z�- 334- 3G38 <br /> duress ZBZ JCr�ER A Ewl4� ' ctt�iswt�ziv EVERe�7 W� 9(�Lal <br /> CONTRACTOR O�p � L 8�Lic.k AP���1I 'O�W' 00 <br /> aereas4� IaMt6Wlt U�E �Tt 2og M�r��o W498L75 Pr�one/emauy25-349-SoU4 <br /> TENAN BUSIHES NAME CONTACT FOR PER IT <br /> US I�EA1.1tiiW0�LC-S Plane/E�mait Q�rQ APOGI�NEDM. COH <br /> dU1LDIN0 PERMIT APPLICATION CONTRACT VRICE OF WORK �'�• �� <br /> Ezisting Use ot Building a CA�r�I LAiE HEAT SOURCE: <br /> ProposedUseoiBuilding *�"�rN GNIc� Ges Ekwtric Otner <br /> Buildin�type: _SingleFamily ,_Duplez Tavnhouse _Mufli-Family ,�Commercial <br /> Type oi projed: _New _AddNion _Remodel _Repair_T.I.�Sign_Sprinkler_Demoldion_Change o(Use <br /> Desaiption W Work(edditiona�spece provMad on the badQ: <br /> �Nsr•� Ul y'x8' icw�+�Nkrte A•�N�J4 <br /> Have you started worklnp wilhout a pertnit7 _YES �NO <br /> MECNANICAL PERMIT APPLICATION PLUMBIN6 PERMIT APPLICATION <br /> Type ol Project: �New_AOdn _Alteretlon_Rapeir Type ol Projecl: _New_Addn _AMerrilon_RepNr i <br /> Show NumDer(ItJ ol R+fures Show Number(�J Mfl+hwes I <br /> AIC—airhandlin unds Toiie� <br /> � Forced air s stems Bathtub <br /> I Gas i in i Lavato wash basin <br /> Walerheater I Shower <br /> Gas fireplace Kitchen sink 8 dis sal <br /> � Gas ran e I Dishwasher <br /> I Clothes d r I Clothes washer <br /> I Ran e hooA Water heater <br /> I Exhaust fan Sink servicelbadmo ete. <br /> I Heat pum Backflow reventer <br /> UNt heater Ufinal <br /> Boiler Drinkin Fountain <br /> Refn eration Floor drain <br /> Woodslove Grease ira <br /> i �udin I Roof dreins <br /> ( I Other ��+� A S�C.1 MedicalGas <br /> SPRINKLER/SUPPRE8SION SYSTEM Other. <br /> � Numcer o(Heads � Olher. <br /> I here6y cerUfy Ihat 1 have read entl eramine0 tMs a�qlicalion anA knox the same lo be Uve and cortect.All qovisbns ol laws antl orOinances govemin8 <br /> thla rype of�wrk will be canplied vAth whelher specifietl t�ert,tin a noL The 9�ntinp ol a pertnit tices no�piesume to give aultrority to violate a wncel <br /> the provision oi any ottier stale or bcal tew regulelinp consWctbn a the perlormerroe ot oonsUuctbn.Thal I am eWhonzeC by the a�er d Mit properly <br /> ro pM e r,ork fw whkh appliratbn fs made and I oomplY with Ihe State COMractora Law 18.27 RCW and 288.20U WAC <br /> � <br /> /�� //•3r�/� <br /> �urlAul�orized Aga�3lpnelure Dete ReNsed?/2011) <br /> Pa.r'd <br /> %a <br />