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PERMIT APPLIC�►TION <br /> BUILDINGIMECHANICALIPLUMBING/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 I" 3 � <br /> VROPER7YTA%M PERMIT� r <br /> SITE ADDRESS: � � "0,�� <br /> �" 1Z ' r+lA � 1��� <br /> LEGAL lor new conslruction-. Shoh Plel/subdrvision Lat No._ (altach copy al long legel descnpllon) <br /> OWNER QO�J Phone�E-me I ZS� 25 ( — �V� <br /> Address � �l✓E cnyis�emrzicE✓�L�� UJf� -r'i'�Zo I <br /> CONTRACTOR +u�J L C=�AS L 8 I Lic.# �A51��P�(S q i3 �"- <br /> nddreseZbl�i u� C11`iti`n `�j�,Z�, ���� � ���'Z�, � Phone/Email � —�} �� �bJ" <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> NEATSOURCE: <br /> �xisting Use ol Building <br /> Proposed Use of Building Gas Eiadric Other <br /> Building type: _Single Family _Duplez_Townhouse __Mul�i-Femily _Commerciel <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change ol Use <br /> Desc�iptiOn o(Work(nddrtional spaca prov�detl on Iho back): <br /> I ��r�� c� c � <br /> Have you etartod working wllhoul a pertnit9 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERAIIT APPLICATION <br /> Typa ol Pro�e�t: _,Now_Addn _Altoretlon_Ropelr Typa ol Pro�ocl: ShowoNumber�(M)ol fl��'��tlon_F.�eir <br /> Show N�mbar/MJ ol lixfurea <br /> A/C-air handhn unlis I Toilet <br /> Forced air s stems Balhtub <br /> Gas pip�� Lavalo fwash basin) <br /> Waler heater Shower <br /> Gas fire lace Hitchen sink&dis osal <br /> Gas ran e � Dishwasher <br /> Clothes dr er Clothes washer <br /> Ran e hood Wate�healer <br /> Exhaust lan Sink(servicelbadmo IetcJ <br /> Heal pum Backllow reventer <br /> Uni�heater Urinal <br /> Boiler Drinkin Fountain <br /> Relri eration Floor drain <br /> Woodslove Grease ira <br /> I p����� Rooldreins <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number ol Heads Other: <br /> I hereby cerlily ihet I have iead end eMemined Ihis epplication end know Ihe same to be tme and conecl.All prnvisions ol lawe end ordinances poveming <br /> ihis typa of work will be complied wil�whelher specifie0 herein or nol The prenlinp ol e permil does not presume lo pive aulhotlty lo violate or Cancel <br /> ihe pmvision ol eny olhe�slate or local lew regulnling constmclion or Ihe pedormence ol conslruclioa Thal I em eulhotlzad by ihe ownor ollhia propedy <br /> 10 p ihe woik lor whic opp ation is madc and I comply wil�Ihe Slete Contreclors law 1B 27 RCW nnd 298.200 WAC �, ! <br /> �� <br /> (��-� � ,,� � l�� � z�� z <br /> OwnaflAu�horizod Apenl Slg�aluro <br /> Daie (RevisedYtOf 1) <br />