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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., �verett, WA 98201 -425-257-8810— FAX 425-257-8857—www.everettwa.om <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: C-�/ PROPERiY TA%p P �T /� ��f,\� <br /> t � 7 Z fl lJ�! <br /> LEGAL lor new construction� Short PlNisuGdrvisinn___ Lol No._ (A��ech copy ol long legal descrip�ion) <br /> OWNER �"' v 1'none/E-meil Ly I l� �U <br /> AdAress q�Q(..� r CitY/:•Inle/Zip �'Ve,r � <br /> CONTRACTOR L 81 Lic N <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �����X <br /> � Phone/E-mail �- <br /> BUILDING PERMIT APPLICATION coN7RAC7 rRICE oF WORK <br /> E�isting Use of Bcdding NEAi SOURCE�. <br /> Propased Use of BuilAing__ Gas Elect�ic_ Olher <br /> Building type�. Single Family _Duplez__Townhouse _Multi-Femily _Commercial <br /> Type ol projecf_New _Addition __Remodel _Repair_T.L_Sign_Sprinkler_Demolition_Chenge of Use <br /> DeSCription ol Wo�k(fldd�hona�space pmwded on f!ie 6acN): � / �l -}�— <br /> . � �..82 _ �rC,u,aLr� jc,/�Pdre, <br /> � �C� /1,�n�x G L ��'� � � � <br /> Have you started working wlihout a permllT _YES _NO <br /> � � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol ProJoct: _Now_Addn _Altarallon_Ropalr Typo ot Pro�acl: _Naw_Add� _Altorallon_Repelr <br /> Show Number(M)ol/ixNrua Show Namber(MJ ol BrNree <br /> ' NC—air handlin um�s i Toilet <br /> Forced av s stems Bathlub <br /> �_ Gas p�pm Lavalor (wash basin) <br /> N,'ater heater Shower <br /> Gas I�re lace Nitchen sink S dis osal <br /> � Gas ran e Dishwasher <br /> Clothes dr er Clothes wa<.her <br /> Ran e hood Water healer <br /> [xhaust�an Sink(servicelbarlmop/etc) <br /> lieat pum Backllow revenler <br /> Umt healer Urinal <br /> �oiler Dnnkio Fnuntam <br /> Reingerahon Floor drain <br /> Wcodstove Greese hap <br /> � Ductmg Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other. <br /> Number o(Neads � Olher <br /> I P tdY Ihnl I havo reatl nnd ezamined this apphcnllon end know Ihe same to be liue anA correcl All provisions ol laws end nrdinences poveming <br /> th�s t voik wtll be wmphed with whether specilied herein ar nol f he grenling ol n permit does not p�eeume lo give aulhorily lo violate o�cancel <br /> U�e prc.. n al any o�her slate or lowl Inw iec�ulating conslruction or Ihe pedormance o�conslruction.That I Bir.eulharized D/Ihe owner al lhis propedy <br /> lo pnimm Ih crk lor hich appiiwlior �,s mnde end 1 comply vnlh Ihe Slate Conireclors Lew 1P 27 kCW and 2'.19 P00 WAC <br /> �� I � l � 1 <br /> ,� � <br /> Owi erlA ho Izod gonl el - Dat (RewsadYlOff) I <br /> ,� <br /> ' li <br />