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PERMIT APPLICATION <br /> BUI LDING/MECHANICAL/PLUMBING/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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADORESS: (� . ') � PflfPEfliYTA%N PERMITM �C <br /> � � ( �� / li; � �� <br /> LEGAL tor new wnelmction�. S�orl PlaVsubdivision Lol No_ (allac�wpy ol lonp leqal tleecrlptloN <br /> OWNER � .��Li�l'14�� Pnone�E�mail <br /> noarese ) o G��S;i�� �t_ <t Ciry�Stele2ip �4/��Ya� tvi� iJ' Z�d� <br /> l <br /> CONTRACTOR ��? � Li �� �� �- �a i uc.a 'Uf�I i� �+Z '� 7 6 � <br /> AEUrese � !��'`� ) A L n1 r' �� Phone/[mail 2 - 7Y —0 7 � � <br /> TENANT BUSINE53 NAME CON ACT FOR PERMIT <br /> 1 O.a b r�,.,� t.:l�. � �1. <br /> C� , �� � �� Phone'E�mail �U����I< Sr � / '" <br /> BUILDfNl3 PE MIT APPUCATION CONTRACT PRICE OF WORK . 2 '�U r-_' <br /> Ezisting Use ol Building HEAT SOURCE�. <br /> Praposed Usa of Building_ Gae Eiec�nc Othei_ <br /> Building type: _Single Family _Duplez_Townhouse _Mulli�Femily x Commerclal <br /> Type of proJect _New _Addilion _Remodel _Repair_7.1,�Sign_Sprinkler_Demolition_Chenga ol Usa <br /> Descriplion ol Work(a�Urtronal spece provitled on tha bacw�: l',, �l� <br /> "ly�rt� w�Il ���� (1 '1� ��'v���t % <br /> Have you etarted working wilhout a parmil9 _YES�_NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol Pro�ecl: _New_Addn _Alterollon_Repelr Type ol ProJecl: ,_Naw_Addn _Allnrellon_Nepalr <br /> Show Number(M)o!fixfuree Sbow Numbm(N)of/Murea <br /> � NC-air handlin umts i Toilel <br /> � Forced eir s slems Oathlub <br /> I Gas ipin _ I Lavalo wash basin <br /> Waler heater I Shower <br /> � Gas fire lace Kdchen sink d dis osal <br /> Gas ran e <br /> � Dishwasher <br /> — � Clolhes dr er Clothes weshrr <br /> Ran e hood I Water healer <br /> Exheus�fan Smk service�bar/mo letc <br /> Heat um I Backllow prevenler <br /> Um�heeter Urinel <br /> Doiler Drinkin Fountain <br /> Rehi eialion Floor drain <br /> Woods�ove Grease Ira <br /> � Duclin Roof drains <br /> � Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I otner <br /> � NumterolHeads � Olher. <br /> I hae�y certiry tna;I Pavo reaU ana e�aminetl Ihi�aOG�����on enC knav Ine same lo�e t�ue an0 corrccl All provis�one ol laws anC ortl�nances 9ovemmg <br /> Ihis lype o/werA w�il�e mmpbeA�hlh whet�er epecAied he�em or nol The Orenlinp ol a permit ticea not presume to B�ve aut�only lo v�oiate or cancei <br /> Ihe pmvision ol a�y othm slate ar local lew requiatinp constmction or tne pedormence ol conslrucOnn. TTat I am aNhonzetl by IFe owner ul lhi�prope�ry <br /> �o periorm t�e woik fe�wA¢h apphcation is ma0e en0 1 comply w�th I�e Slale Conlraclore lew 1B 27 RCW and 2B0 200 WAC <br /> � � ..� � � <br /> ' � 1 <br /> OwnorlANhotl:etl Agen!Slpnalur� � �� �t�I Z (Revrxd?1201Q <br /> /� <br />