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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810-FAX 425-257-8857 -wvvw everettwa org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE AODRESS: PNOPERTY TAN q PERMIT M <br /> u � vo 00 UoHO.'� / //- <br /> LEGAL lor nuw consVucuon� ShoA PlaVsubtlivision�_��!�_�A1�_ Lol No Y. (attach copy cl long iegal descnpllon) <br /> OWNER ,$ J P�on�/E�m�il 1 6- 0 . � <br /> Address (� � �/ CAyISIaIcIZip /�(L U <br /> CONTRACTOR U L 8 I lic.M V U,� / <br /> Addrcss , V, Phone?mail <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> �D� # ZRQ8r6 ,��� Ka. - - 6 S�i <br /> P�one/E�mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE Of WORK �"-��'— ,j2S 7J` <br /> Exisung Usc of Bwlding HE�T SOURCE <br /> Proposed U5e ot Building S �/� Gas _ Flectnc� Othar__ <br /> Duilding type- �ingle Famdy _Duplez_Townhouse _Multi�Family _ Commeraal <br /> Type ol pro;ecf New _Addition _RemoAel _Repair_1.L_Sign_Sprinkler_Demolition_Change ol Use <br /> DCscrip�i0n Of Work(addihonul spaco p�ovidvd on tho back): <br /> GJf��RUt�' NE.�J .S✓N4�E `�h.ZL�' .�S,S'/QC.vCE' <br /> Nave you staAed working withoul a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol ProJoct� KNow_Addn _Allonllon_Ropalr Typo ol ProJoct: '�Now_AAtln _Altoratian_Ropalr <br /> Show Numbcr(M)ol/ixtures Show Num6er(N)ollixfures <br /> A/C—air handhn umis Toilel <br /> Forced av s slems Bathlub <br /> Gas pi m $ Lavalc (wash basm � <br /> Waler heafer Shower <br /> Gas hreplace Kdchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clolhes dr er Clothes washer <br /> Rangc hood <br /> r Fehaust lan Smk(servicePoai/mopletc � <br /> Hcat pump Oac60ow p�eventer <br /> Unit heater Uiinal <br /> Boder �rinkin Fowilain <br /> Rcln eration Floor drain <br /> Woodstove Grease liap <br /> Duchn Hool drams <br /> Olhcr Medical Gas <br /> SPRINKLER / BUPPRESSION SYSTEM Olher. <br /> Number ol Ileads Othcr <br /> 1 hereby cerUfy Ihal I have read Dnd examined Ihls app6cation and koow I�e same lo Co Irue anC correcl Ail piovisions ol taris ond o�Umances gwemmg <br /> Nis type ol work w�ll be comphed wnh w�ethei spec�GeC�ere�n or nol. iha grani�ng ol a perm�l does not presume l0 9ive aulhonly lo violate or wncei <br /> the prow;ion ol any othei slale or bWl law requlatmg consWq�on or Ihe pcAormancC ol consWcOon. l�at I am aul�onzrd Dy IAe owner ol I�is D�opetly <br /> lo perlo�m Ihe wo�k for wAich app6 ahon is made.nd�comply wilh Um::lale Co�dnclois Lnw 1B P7 RCW and 778 700 WAC <br /> ��. � i�� - � <br /> OwnorlAut�orlxodA en Sign�turo Dale (Revisnd7/.`011J � I <br /> / � <br />