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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257•8810- FAX 425-257•8857 -www everettwaL.org //,-AS""� 2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 1,` ( � - OO� <br /> SITE ADDRESS: /� vnOaEaiv inx a PERM�T I <br /> 36`v 3 �'�'i�- �YS w. .Ynn Lp /S(DL Skr�u� — <br /> LEGAL ror new consuuctioa snon i�iausuea���s�on /`)C�� �� Lol Na_ lallach copy ol long legal Oescnption) <br /> OWNER gdE�,V, PhonelE�ma�i <br /> Address City/S1atMZip <br /> CONTRACTOR ,��/ ,�=?-'.9-t� � �-7 C L 8 I Lic N <br /> �l����fi•'2�'a0<.L �'3-/n06../2ii <br /> Addiess ��O�J/ CQ,qcc�G�"ii ll� �'-'P� P�one/Ema�F� v �� -y../r�srqeBP�2.��5� .,: <br /> TENANT BUSINESS NAME CONTACT/�F R PERMIT <br /> /(�"��/V� �:S:4i!4[b.�'Oi��' ��%p <br /> PnoncrE-maJ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> [xisling Use ot Buildmg HEAT SOURCE� <br /> Proposed Use ol8mlding` Gas___ Eleclnc___ Olner_ _ <br /> Buddmg type _Smgle Family _Duplek_Townhouse _MuIU-FamJy _Commcraal <br /> Type ol pro�ecl _New _Adddlon _Remodel _Repair_T.I._Sign_Spnnkler_Ocmolition_Change of Use <br /> Description ol Work(adtl�hnnal specopmvrdetlon Ihe Dack) <br /> p�51dL 9 �"� SY�1� <br /> . �! S��N,�.�=• �D�lb d,.�-s�dn <br /> Have you sUrted working without a pertnil7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJocl: _Naw_Addn _Altantlon_Rap+ir Typo ol Pro�ecf� _New_Addn _Allention_Ropalr <br /> Show Numbcr/NJ ol/l�tures S�ow Num6er(N)oI U�fures <br /> A/C-art handlin umts T011e1 <br /> Forced av s stems Dalhlub <br /> � Gas iping Lavato (wash basin) <br /> Walcr healer Showcr <br /> Gas fireplace K�Ichen sink 8 d�s osal <br /> Gas�an c Orshwashr.r <br /> Clo�hr.s d er Clothes washer <br /> Ran c hood Waler healer <br /> Ex�ausl fan Smk(service�0admop/elc 1 <br /> Heal urnp Backllowproventer <br /> Uml hcalcr lL�nal <br /> BoJer Drmkm Fountain <br /> Refr� eration Floor dra�n <br /> Wuodstove � Greace Irap <br /> Dur,hn Rcof dra�ns <br /> Olher Med�cal Gas <br /> SPRINKLER / SUPPRESSION SYSTEM o�h�r <br /> INumhei ol Hcads I Olher <br /> I hereoy cer6ly Ihal I havr ieatl anU exammeA In�;aOP��caUnn anC know Ine same lo ha Irue a��d Gonetl Fu pro��s�ons o�laws and o�dm:mce.govemmg <br /> Ihx lypC ol woh will he ComplicA wil�whcl�or 5pe[�GCO hoiein oi noi ihe 9�ant�nn o�a peimil does noi p�esume lo grve aulhmily lo violalc or canccl <br /> Ihe pmvrsion ol any olner slale or local law rcyulalmg r,onstruchon or Ihrt pedannanr.e ul cnnslruc6un Thal I am aut�onre��y Ihe owner ol Inis p�operty I <br /> lo pedoryn�e woih�oi nich apP���afon u ma�1e and I r.omplY wdn Ihe Stale Cr.nhactoix Law 1817 HCNJ antl 25f,7f10 W�C '2 <br /> � O��N,�t��� /0 -,Z 9-/Z <br /> OwnerlAulhor�d�Agen1 Sipnalura Oale (/7emsud'1/d0 i r� <br />