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PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �2 <br /> PROPE IYTAKII P MITJl,�3 _�.3 <br /> SITE ADDR S : / �a �, � 7 L <br /> LEGAL tor new conclruction: ShoA PizUcubCivisio �,�✓ � _Lot No._ (aUach copy ol bn0 kGal tleealption) <br /> OWNER Phone/E�mail 7�J� R� t ^� �1 <br /> Adtlresa sJ� / � r.� CIry/51ate2�D � v <br /> CONTRACTOR 1 /,, <br /> � AV 5 ���,9 L 8 I Lic.# 4.I- E <br /> �! / I (( r V �d DI l I' S • .� <br /> AOEress ��K Il il1 ✓1� f�. � �' PhonelEmail d. � f!� ' <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �f � " ' <br /> Phonei6mail �� � I J� l 1� ��1 � � � <br /> BUILDIN6 PERMIT APPLICATION <br /> CONTRACT PRICE OF INORK � �� � ��' <br /> HEAT SOURC : <br /> Existing Use of BuiWing, <br /> Gae Eleciric Other <br /> Proposed Use ot Building <br /> Building type: �S�ngla Family ,_Duplex_Townho se _Mu i-Family _Commercial <br /> Type oF projed: _New _Addflion _Remodel �Repair�T.I._Sign_Sprink�r_Demolillon_Changa oi U�e <br /> DesCrip!ion Of VJork(aadifionel space provi0e0 on the batk): n��(9r�^ �'� �/q`1j.�l�n �. <br /> KN � �,r rn �� �i <br /> Have you slarted working withoul a permit7 _YES �NO <br /> MECHANICAL NERMIT APPLICATION PIUMBIN6 PERNlIT APPLICATION <br /> Type of ProJecl: _New_Atldn _Allerntlon_Repair Type ol ProJect� Sho Number�(MJ ol Ilxlutrea'I on_Repair <br /> Show Number(N)olllxfures Toile� <br /> A/C—airhandlin units � Balhtub <br /> Forced air s stems <br /> � Gas ipin La�ato wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 dis osal <br /> Gas ren e � � DisGwAsher <br /> Clothes dr er I Clathes washer <br /> Rsn e tiood Waler heater <br /> Exhaust lan Sink(service/barlmo /elc.) <br /> Backflow reventer <br /> Heal ump Urinal <br /> Unit heater <br /> Drinkin Foun�ain <br /> tioiler <br /> Floor drain <br /> Refri eration Grease Ira <br /> Woodslove <br /> Roof drains <br /> Duclin <br /> � Olher Mediwl Gas <br /> SPRINKLER I SUPPRESSIOH SYSTEM I Uther: <br /> Number of Heads I Otfier: <br /> I hereby certity thal I have read and ekamineE Ihis appliralbn anA know the same lo be true and corred.A�1 pmvisione of laws and ord.��ences Qoveminp <br /> ihis rype of work vnll be wmplied vrith whether specifed herein o�nol.The pranlinp ol e permA dces not presume lo g��e aulhonty ta violale or cancel <br /> the provislon ol any other stale or local law regulaling cunstruclion or Ihe pedormance ol conslruclion.That I em authedzed by Ine owner ol this pro���Y <br /> to peAorm the vrork br vfiic�application is made and I compy�with Iha State Conlractors Law 18.27 RCW anC 2B8200 WAC <br /> ' / ��_/(/ <br /> /C� �W"� �' �- (Revlsetl7J20f7) <br /> OwnerlAuthorized Agenl Signature �ate <br />