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i <br /> PERMIT APPLICATION <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 e AM TO 1 PM �I I Z <br /> BITE ADDRE8S: � '1 VROPERTY TA1f N PE�� � <br /> �� 1� � .^ c�•! n /=�. '��- S g > - C7J <br /> LEOAL lor new con�Uuctlon: Short PleVauedivinlon Lol No._ (etl�ch wDY ot loip le9el de�criptlon) <br /> OWNER '^h� 'rl �-+ Phone/E•meil <br /> Atldrae� CltylSlete2lp <br /> CONTRACTOR � T G I� I f ('�C�� �•� L d I Lic.k <br /> Addro�� Phone/EmHI <br /> E T BU I NA E CO T IT I, ,rL�2 � r `k � <br /> ���I rJG P�onelE�mell �"•C���h� - <br /> SUILDINO PERMIT APPLICATION CONTRACT PRICE OF WORK 2-S' �4 <br /> Ezistinp Uee ol Building HEAT SOURCE: <br /> Propoeed Use ot Building Ge� Ehdrie Othe� <br /> Building type: _Singte Femfly _Duplev_Townhouse _Mulll-Femily _Commerciel <br /> Type ol pro�ect: _New _AddiUon _Remodel _Repeir_T.I._Slgn_Sprinkler_Demolitfon_Chenge of Uee <br /> DeScdptlon ol WoAc(eddifbnel apece prvvlded on fha becNJ: �fl v V <br /> (��F .,N �� ,�L'� WtiopvL-r� i=:+r,, h NS ;� <br /> H�ve you�uAed worklnp without a permit7 _YES �p�NO <br /> MECMANICAL PERMIT APPLICATION PLUMOING PlRMIT A�rLICATION <br /> Typs ot Pro��ct: _N�w_Addn _Attentlon_Rep�lr Typ�ol Pro��et: _fNw_Atldn _Albntlon_R�pNr <br /> ShowNumber(N olllxtuns ShowNumMr ofNxfun� <br /> AIC—air hendlin unila Tollnt <br /> Forced eir s elems Bethtub <br /> Gas i in Laveto weah beeln <br /> Weter heater Shower <br /> Gaa fire lace Kilchen aink B die eal <br /> Gae ren e Dishwanher <br /> Clothes d er Clothea wenher <br /> Ren e hood Weter heeter <br /> Exhaust fan Sink sarviceroarlmo /etc. <br /> Heet um Beckllow reventer <br /> Unit heeler Urinal <br /> Boiler Drinkin Fountein <br /> Retri aration Floordrain <br /> Woodstove Grease Ire <br /> Ductin Roo/drelns <br /> Other Medical 6as <br /> SPRINKLER 1 EUPPI2ESS10N sYBTEM other: <br /> Number of Heada Other: <br /> I hereby ceA�N�het I heve raed eiM eMemined thle eppllcallon and know tM eeme ta bs tiva end corted.All provlebna ol lawn end ordin�ncee povemirp <br /> Ih�s type of work will be compllad wllh whethar speclflaA hercin or not.The pranllnp ol a peimlt tloe�nol preauma to pive eutMrlty ta vblele or rancsl <br /> �he provlslon ol eny other nlele or locel lew repulellrp wneUuc�lon or Ihe pe�tormence ol cont�rudlon.Thel I em eW�o�lted by tM ovn�sr ol lhl�propaM / <br /> �c ped rm tha work lor whlch ap Ilulion�1 mede end I comply wllh tM Stets Contndon Lew 18.77 RCW and 280.200 WAC ' Z <br /> �i�ibl.�,/,�.� �... ,.��!.� � ���� ��1/. <br /> Ow rlAulhorizsd Ap�nl 81pn�lun Dtla �R°W°°d���� <br />