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PERMIT APPLICA'fION <br /> BUILDING/MI�CHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITIOH <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810-FAX A25-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SIT�AQ�TESS: v OPEniYTn% � �I7x y V\ 1 <br /> ��� � c ��,�` >> 'l� � <br /> LEGAL fw new conslrucLon'. Short Pbl/subCins�on_ Lot No._ (attach copy of long legal descnpGon) <br /> OWNER �� � PhonelE•mail `�f�s ,�'u—�1 <br /> ACdress ��- `j � City/State2ip � C (Q — <br /> CONTRACTOR - -S'I C�f�{ f - 1 L 8 I Lic.# � — <br /> r. <br /> AOCress 2� (� _ _n�?� t �. , . � � - C Phone/Email 3 �._ �j— .L� <br /> TENANT BUSINESS NPJ�IE CONTACT FOR PERMIT r,11 CK �1 L'+�gt:DS <br /> Z.— SI�C'�r Phone/E-mail �U,CI c� ZC, �• 'Ci 1 � ' 'r " 1 Qi}�l <br /> BUILDING PERMIT APPLIC.AT{ON CONTRACT PRICE OF WORK 1 1 ( <br /> ExistingUseotBuilding ��,lblNlifj'C� lial HEA7SOURCE: <br /> Propose,i Uae o(Building �� �� Gas Electnc Other <br /> Building type�. _Single Family _Duplex_Townhouse _Multi-Famity ✓Co mercial <br /> Type o(projecC _New _Addi6on ,Remodel _Repair_T.I.„� �gn pnnkler_Demolition_Change of Use <br /> DCScriplion of Work(eC0ilional space provitled on the back): �n{�;�L [—L�c�1�0��C MtS�Sh�(-� n����L�� ��I� <br /> I��OIv�1w1CN 1` S'j1��1C"il�4E W I'T11 I17 (`A1311�iC�}- Q <br /> / <br /> Nave you sGrtad working without a parmil? _YES ✓NO �� y <br /> lJIF.CHANICAL PERMIY APPLICATION PLUMBING PERMIT APPL CATION <br /> TypeofProJect: _New_Addn _Alteration_Repair TypaofProjecl: _New_Addn _Alteratlon_Repair <br /> ShowNumber a olfixtures ShowNumber M offix�ures <br /> AIC—airhandlin unds Todet <br /> Forced air s stems Bathtub <br /> t Gas i in� i Lavato (wash basin <br /> I Waterhealer I Shower <br /> i Gas fire �lace I Kdchen sink&dis osal <br /> I Gas ran e ! Dishwasher <br /> � Clothes d er ! Cbthes washer <br /> I Ran e hood I Water heater <br /> I Exhaust fan Sink�serncalbadmo �elc. <br /> I Heat��um I Back9rnv preventer <br /> Umt healer I Unnal <br /> Boi�er I Dnnkin Fountain <br /> I R�_frigeraGon I Floor drain <br /> I Woodstove Greasetra <br /> Ductin I. Roof dreins <br /> I Other � Med�cal Gas <br /> SPRINKLER /SUPPRESSION SYSTEM Other <br /> � NumberofHeads � Othe•: <br /> I hereby cerLy that I have read and e�ramineC this application end know the same ro be true erM cortect.AII provisions of laws en0 ordinences povemirq <br /> this type of work will De comptied xtith whether spedfied herein w�ot.The 8ranting of a permit tices not presume lo give auUority to vidate or cancel <br /> tne prwis�WW n of any ot�er state w b al law reyulatinp consWction or lhe perlortnance ot constructwn.Thai I am auUrorized by the wmer of tMs propeRy <br /> to pertoml'the v.ork for��dfEppl^ �on is made end I comply with Me State Conhactors Law 7827 RCW and 296200 WAC <br /> / <br /> / ( r,��� �t /�� /� � �:�l� l ,� <br /> OwnedAuthodzed Agent Signeture Date (Revise0?/Ylf f) <br /> `Iz <br />