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, <br /> . . � • �� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425257-8810—FAX 425-257-8857—www.everettwra.org <br /> APPLICATIONS ARE ACCEPTED FROM t AM TO 4 PM � JJ '— I <br /> SITEADORE55: '7 ` VNOVERTYTA)(11 �� P IT1I <br /> LJ <br /> LEGAL!or new aonstrumon� Shon Piat/subCms�on Lol No_ (eRaCl�mpy of lorg legal EeAo�06onJ <br /> OWNER � P�onc/E-mail ZS 25 -3�O,3b <br /> a� I v ��,�o � <br /> CONTRACTOR L 8 I Lic.M <br /> eress � �[ a�� . • I� I 1� /Q Q6?.3� PhonvlEmatl �fDO / —VQ� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT � �O�y <br /> � PhonelE�nail LtT� �CN/+i � �Q m <br /> 9UILDING PERMIT AP�LICATION CONTn,�cr v�cE oF woRK <br /> F_u�sling Use ol6uildmg I HEAT SOURCE: <br /> Propo�..ed U5¢of Building C�[� Gas Eieane Other <br /> Buildmg type: �„Single Famlry _DupMY_Townhouse _MukiFamlty _Lommerual <br /> Type at projeet _New _Addition _RemoCel _Repair_T.I._Sign_SD��kler_DemolNon_CAange of Use <br /> Desviption ol WDAc{aadmcnal apace p�ovNed on Ne beck): <br /> rc- rvc� <br /> Mave you started worfcing without a psrmit? _YES ,�,NO <br /> MECMANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> ryPe m vro�cc _new_�aa� _�n�rar;o�_nspetr Tyoe a arqea: _naw_�ean _�ncre�,on_as�tr <br /> SAow NumDer M ��� SAor Num6er ol fi+eerss <br /> AIC—air handli unRS Toilet <br /> Forced air s fems Batntub <br /> Gas i in Laveto wasA basin) <br /> W;ter heater Shower <br /> Gas fire lace IGichen sink 8 tlis osal <br /> Gas rsn e Dishwasher <br /> Clothes d er . CloMes washer <br /> Renae nood Water�ealer <br /> Ex�aust fan Slnk serviceJbar/mo /etc. <br /> Heat um Backflaw preventer <br /> UnM heater Unnal <br /> Boiler Onnkmg Founfain <br /> Refigeration Floor drein <br /> WooCstove Grease tre , <br /> Ductin Roo1 d2ms <br /> Other Medi�al Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Otner: <br /> Number ot Heade Olher. <br /> 1 hereDy oartiry thet I heva�aed and mmmineA Nie appliceUon end know Ne semo to be wa ercJ mrtect al p;ohsions ol lawy end ord�nanc¢s goveming <br /> Nis type of hork vnll be complred wiM v,fiemer spe�ifie0 heieim m�ot.The grerthng o1 a pertnit Oces not prewmo to give authon,y m violate w can�ei <br /> � the ptovision ot anY other state o�lowl lew reguleLnB constrvcti0n o�Ihe perlortnanoe oi construWon.7Tet I am euthonreE Dy Ne rnmer of Mie O�GeM <br /> lo pe Iha Mork epplicetiaq is matle end I comply wiUi Lno Stato CorNapors Law tB.�7 RCW and 296.200 WAC <br /> t�uu'O �.�—l3� . <br /> o.h,annw,w;�anyeMsie wre oece (Re�:ea�noti) <br />