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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGNISPRlNKLERIDEMOLITION <br /> CITY OF EVEFiETT PERMIT SERVICES <br /> 3200 Cedar St., Evered, WA 98201 425-257-8810 FAX 425-257-8857 wv✓w everetriva org <br /> � -�13 <br /> SITE ADDRESS: PROPERTY TAX p PERMIT q <br /> D�-'G27� <br /> LEGAL Iar new mnslruclion�. Snort PlaVsu04ivis�on I.ol No. (attach copy ol iong legal descnplmn� <br /> OWNER � Phone/6mail <br /> AdGress Gty/Stale/Lp <br /> APPLICAN'f: O�vner _OwnefsAgent _Contraclor _ContractoYSAgent Tenant�m�seo�o�co�ie�erc+w�:e,�vcmmao+�rerueowoa��o�n,so,o�� <br /> CONTRACTOR Stale Lic. # Gty Bus. Uc. # <br /> Atldress p � � � Phone/Email <br /> TENANT BUSINE55 NAME CONTACT fOR PERMIT <br /> Phone/E-maJ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK�Q <br /> Existing Use of Budding HEAT SOURCE <br /> Proposed Use ot duilding IZ� (ZOY9� Gas____ Eiectnc_ Otner._.__ <br /> Bwltling type: �Single Famdy _Duplex_Townho e _Multi-Family _Commercial <br /> Type of DrojecY New Add�tion Remodel Repair_T.L Sign_Sprinkler_Demolit�on Change of Use <br /> DESCR,IP7TION OF WORK(ado�r�onarspace providedon meaace): <br /> hF F�6�'F . I <br /> CO�t��7S+`r� OrJ �JEQ. �kt�Ttr.1C� IZp�p� <br /> MECHANICAL PERMIT APPLICATION PLUMBIhG PERMlT APPLICATION <br /> Type ol Projecl: _New_Addn _Altera�ion_Repair - Typo ol Pro�ecC _New_Addn _Allera�ion_Ropatr. - <br /> Show Number Ipl o/lixfures Show NumbCr(p)ol lixtures <br /> NC—air handling umts Todet <br /> Po;ced air syslems t3alhtub <br /> Gas p�pmg Lavatory pvash basin) <br /> Waler healer Shower <br /> Gas freplace Krtchen smk 8 disposal <br /> � Gas i.��9e Dishwashcr <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust lan Sink(servicelbar/mopletc.) <br /> Heat pumD BackOow preventer <br /> Und hCaief Urinal <br /> 8aler Dnnking Fountain <br /> Relrigeralion Floor tlrain <br /> Woodstcve Grease Irap <br /> Ducling ftoof drains <br /> � ORicr Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Oiher: <br /> NumberofHeatls � Other: <br /> ,neieE�ceNly ihal l�nve rca�anE e�ommeE tMs apPi:cabon antl tnow�hv same io be vuo and corretl.All provlsions ol lews on0 or��nanms 9oveming ihis lype ol wvrk wdl De mmpi�cd <br /> xit�wnelher specPeC�erein ar not.T1ie granling ol a pertTA tlocs nol presrmc l0 9ive aWpaniy Io violale or Cdntel I�e pUvision ol any a1�er slBle or laal law regulaLng mnslmclmn <br /> IDat I am aulnonzed by t�e cwner of I�is pmperty lo peNorm Ihe work for w�i:h appl.r,bcn Is made ana I wmply wn�I�e Sla�e Comraclors law 1B 27 RC W ana 296 2QJA�1AL <br /> $� � - I� <br /> 0 odAul ' ed genlSlgnaWre Da�e (Revised34013) <br />