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,. . � ( <br /> PERMIT APPLICATION <br /> ( BUILDINGIMECHANICALIPLUMBINGlSIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SFRVICES <br /> 3200 Cedar St., Everett,WA 99201 -425-257-8810-FAX 425-257-SB57-wwrv.everettwa. rg <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM I OG �I <br /> SITE ADDRE53:, PROPEIm TAx M � Ar <br /> � G <br /> LEGAL for new construction Short PiaVsubtlivision Lot No._ (attedi coPY�b^G�I descript�oN <br /> owneR o -n► O Phone/E-meil �-lZS 330—�{3�/1 <br /> AOaress �- City/StatdLv V W T 0�� <br /> CONTRACTOR / , L 8 I Lic.M <br /> Pddress � �(/. /v PhondEmail : '�'!'77S"cl�l0 <br /> ENANTBUSINESSNAME C NTA T,�-' � �CL{� <br /> Ph��i���L ��i' �' <br /> SUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> NEATSOURCE: <br /> Ezisting Use ol8uilding <br /> Proposed Use of Building Gas Eiectr�c Other <br /> Buildingtype: ,�SingleFamily _Duplez_Townhouse _Multi-Family _Commercial <br /> Type of proJed: _New �Addition _Remodel _Repair_T.I._Sign_Sprink�er_Demolition_Change ot Use <br /> DeScriptionotWork(edd;6onelapeceP�vWedon:`obackl: �f0L.�9G'E LXI$n�G" C'AS �Lf�k� W 1� <br /> Necv G�1s �1�eNArE T,iJ .Sq,'Y►� LOCA'r►dn1� Nd N� �FS P�O��/�. <br /> � Have you started working without a pertnl[7 YES ,�VO <br /> MECMANICAL PERMIT APPLICATION PLUMBINO PERMIT APPLICATION <br /> TypeolProJocl: _New_Adtln �Itarellon_Repelr � TypadProject: _New_Adtln _Alterallon_Rep�lr <br /> SAow Number A' ollAtvna SM1ow Number It o!flxtures <br /> A/C—airhandlin units Toiiel <br /> Forced air s slems• Bathtub <br /> Gas pi in <br /> Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osel <br /> Gas ran e Dishwasher <br /> Clothes d er Clotbes wesher <br /> Ran e hood Water healer <br /> Exhaustfan Sink(servicelbarlmo /etc. <br /> Heat um Backflow reventer <br /> Unit heate! Unnal <br /> Boiler Drinkin Fountain <br /> Ref$eration Floor drein <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER 18UP�RESSION SYSTEtA aner: <br /> Number of Heads Other. <br /> 1 here6y certify thal l hzve read aM e■amineC this epplication eM know the same to be true an0 cortecl.NI proviclona ollaws end or0inencea povemirq <br /> this type o1 work will be comp�ietl vnth whether specified herein or nW.The prentlnp of a permit tices nW preeume to pive autMrity lo v'rolate or cancel <br /> � the prwision of any olher sWle or local law reguleting tonsWction a the peAortnance o1 consVuclian,Thet I am euNorized by the ow*ier M this property <br /> to peAorm the rk lor which applicalion Is nd I comply vrith Ne SW C cton Lew 1827 RCW and 296.2D0 WAC <br /> N (ReVlsed?/l017) <br /> Owna orl Agant5lpnatun 1e <br />