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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOL.lTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 -425-757-8810— FAX 425-257-8857 —www everettwa org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: , VIIOPENTYTA%p RMITp7 � I� <br /> , �. � ���1 c�C�� <br /> LEGAL lo�new conslmction Shoq Piat�subArv�sioq__ I.ol No_ lattacn copy oi iong iepai tlescnplion) <br /> i � r <br /> OWNER �� \l:� � � ��' ' �a:{� PhonaE.mad rt,L.c. � �{.��.� � l l •�y : <br /> Addiess � � L City/Stalei2�p <br /> '_ � � <br /> CONTRACTOR � � IUc.# _ <br /> . � '; ' ' ` , �l <br /> �� Addrese '. �' . . .� <br /> �� TENANT BUSINESS NAME ��/ p ��' CONTACT FOR PERMIT I - <br /> � �I��C^ Pnane�6mae 1� I •d I .t W � (7r-� � Y� l - 1' '� l� <br /> BUILDING PERMIT APPLICATION CONTRACT PNICE OF WORK iI'� ' _ <br /> Existing Use ol8uildiny HEAT SOURCF�. <br /> Pioposed Usa cf Building Gaa E�eanc'� Other <br /> Building type: _Single F�mi1y _Duplex_Townhouse Mulli�Femily _Cammercml j <br /> Type of pro�ecl: _New _Addition _Remodel ,�Repau_T.I._Sign_Sprinkler_Demolitlor_Change ol Usa � <br /> Descriplioi ol Work letlaeionai space provitled on fhe bactil�. � <br /> 7 <br /> /r . � �/ ' -.y <br /> � , �(' i1,i�i "•� .jt 1\��-� 1 �1 t•1 i•li.id �41�'� �p��� �+� i.C� �/ 1 <br /> Have you started working wllhout a permll7 _YES��NO ` Q <br /> MECHANICAL PERMIT APPILICATION PLUMBING PERMIT APPLICATION � \M <br /> 7ypo ol ProJect: _New_AAdn _Allerntlon_Ro�elr Typa ol ProJect: _ New_Addn _Al(eretlon_Repalr v � <br /> Show Num6er(Ml of/trfures Shc�Number(M�olOrfurea V;I � <br /> � NC-en handiin units Toiiet � <br /> � forced air s stems Balhlub <br /> I Gas ipm � Levato �wash basin) � <br /> Waler heater Shower 1 <br /> � Gas fi�eplace � Kdchen sink 8 dis osel -' � <br /> � Gas ran c ; Dishwasher s <br /> Clothes dr er I Clothes washer � <br /> � Ran e hood I Waler healer � <br /> � Cxhaus�fan I Sink�service�barimop�elC.) <br /> ��Pa�Piim I Backllow preventer �n <br /> Unit heale� I Unnal <br /> [loAer I Dnnking Fountain - �' 2 <br /> � liehigerauon I I'loor drnin C� U <br /> � Woodstove ! Grease Ira <br /> I Uucun I Roof drams � � <br /> — � � MediwlGas � <br /> Other_ '• � <br /> SPRINKLER / SUPPRESSION SYSTEM � Umer <, 7 <br /> i Number ol Heads � 0!her Q �J <br /> I hemoy cerory inat I hr rea�a�A e.am�nra Ih s epF���uon antl Ano,v Ina same lo be Ime ara rortecl Mi pmvimons al I:nvs e�a or0inericea povennnq '��� <br /> Inis type ol wo�k wJi be comD��ed wnh wneU�er•peaheA nerem or iwt The g�a�ling of a perm�t tloes ncl presume lo pive eutnonty lo vio�ele o�cencel ���^ <br /> u�e pfovi�o�f n�dhei stale or Ixal law re�ulat�ng mnslruclion o�Ine DeAo�ma�:ce el co�sVuction ThOi I Bm BUIhOnle�hy I�e o.vnlr ol I�i�plOpeffy <br /> tb pqlurrrflhe nwh loi wRich app�ic \�•��a0e anE 1 cOmply wilh Ihe Slala Contractem lxH 18?7 RCW anE?98 I00 W4C <br /> �`� � .. <br /> � <br /> OwueNAUUiuJenJAgentSlgnnlure �,,�/�J f}�n lNensed7R0f0 /.m /� <br /> 1 1 / `�� <br /> I��U�!�� � <br /> � '1`���J --- , <br /> �- -- . <br />