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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, WA 98201 - 425-257-8810 —FAX 425-257-8857—www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM —I N —( Y <br /> SITEAD�RE55: vnov[qTrtAxa r Mit <br /> ;��o; ��l, '' .� ;.,.� �i'^ # - � � �OI - Oug <br /> IEGAL lor new consiroclion Shon PlaUsu00rvision I ol��o (allac�copy ol long Iegal Descnplron) <br /> UWNER �:�I'1 / Phone.'[�inml <br /> Address GlylStalclZip <br /> CONiRACTOR I 5• L 8 I I.ic lt <br /> nae�ess rno�ar.m��i <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> �y� ;n/ �> i�<;;,IV�cr✓ ^�,v 'c� � ;*f <br /> - ;.f•->il/{n;� , ��P�o�_:,_ <br /> rnonr�f.n,ail <br /> BUILDING PERMIT APP�ICATION CONTRACT PRICE OF WORK �.? o:�v.:�•�v <br /> Lzis6ng Use of dwltling HLA1 SOURCF <br /> ProposedUseul9wlding I�`� �-��< <'�f nK � ���� .. <br /> _ _ ___ , __ Gas Fleclnc Olhcr <br /> __. __ ' <br /> Building type _ .Singie FamAy __ Duplex___Townhousc _Mult�-I�am�ly ,L Commerual <br /> I ype ol pro�ecl �New _Addition _Remodel __Repair______T I . _S�yn _Spnnkler. _.�emohhon_Change of Use <br /> Descnphon o�Wo�k�adOdionai so�ce prov�tlod on f�e b.�ck) <br /> �J>„rrr.u, r e,s �.� :��,_, ,•, t � � /'_r ,i� �Cn <br /> Havc you started worXl�g without a permit7 YES y__NO <br /> MECHANICAI PERMIT APPLICATION P�UMBING PERMIT APPLICATION <br /> Type ol Pro�ecC _New_Atldn __Alteratlon_Ropalr Typo ol Pro�ecC _Now_Atldn __Altenlion_Hepalr <br /> Show Numher(a)ol Irr fures Show Num6er(p o/li+fures <br /> I NC a�r handimy unils I TaIM <br /> Forccd art syslems Hathlub <br /> Gas piping I.avnlory IwaSh Aas�n) <br /> Water heater I Shov�er <br /> Gas Inuplaec KdUien sink 8 disposal <br /> Gas range Uisnwasher <br /> Glnihcs drym Clothes w;ishcr <br /> Range I�ood W.Icr hr.alei <br /> I..hausl lon S�nk I�crv�udbaUmaplcic ) <br /> Henl purnp Hack(Ipw pievon�of <br /> Urul henlcr Urin;d <br /> Boder UnnLmg I ountain <br /> Relnyr.ralion floo�d�ein <br /> WooAslove Grease Irap <br /> Ductniy �---� ROoldrains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM olhcr <br /> � Numbrt of Hn;ids Othcr <br /> I I�ou�Ly certdy Iluii I h:rve ica�l dqA c.amnu•d Ihis aypbr.aliun anA knmv Ihrt•dune l0 6R�ri�p,nd cnm�r.t �II provisiun,nl laws anA nrAmanu�5 gnve�nmg <br /> �Ius lyye ul wmk wJl hu t.um�picA w�th wli��ih��i spculretl heri�i�ur nnl 1 hn g�anbng ul�p���nul Anrs nol presurne lo yivn aulhoi�ty In v�ol�te m cancel <br /> Ihe Provitinn ul nny otlici sl;��e m Incli law irqulqLng cum,imdion oi Ihr prdonnance ul�on,hwlwn tliit I �vn aulhon�eA by Ihe owner ul Ilus yruperry <br /> In pedmm Ihe wm4 Im whu.�apphcal�on is maAn anA I com0ly wtlh Ihe Slale Cm�ln[Img I aw 1H 77 HI:VJ and 240 JP0 WAf, �� <br /> '��; � -�� �:��� � •�� -__'���'-1 _a/7� � <br /> OwnotlAulhmliotlAgonl5lgnaturo I�ab�-�� iNr��•,��d7OrJi 0 <br />