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PERMIT APPLICATtON <br /> BIiILDINGIMECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, WA 98201 -425-257-8810 - FAX 425-?57-8857-wv,nv.eveP�retlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM O —� �'�Z <br /> PROPERTYiA%p �T �0 .� <br /> SITE ADDRESS: .` / ,; ,�C ;I'� .1 '� i � <br /> LEGAL 1or new consirucbon: Shotl PlaUsubdinsion Lot No._ (altach copY ol lona legal de5cripUon) <br /> �zf .e.. -' � nC'�L. <br /> OWNER -•� '} � ON Phone�E-maii <br /> Adtlress � ��(i GtylStale�Z�C .�� N' � <br /> CONTRACTOR � z �N'- a.�uNl- E+��M�C L E I Lia li � �J'T ►'-� <br /> AdC�e�. 4 �� � �� �v Phone'Email Z. � C,y � � <br /> TENANT BUSINE55 NA E - CONTACT FOR PERMIT <br /> Phonc'E-mad G•.� • L S d � � '��� C � vG ��' � <br /> BUILDING PERMIT APPLICATION coNtRACTPRICEOFWORK � <br /> ti L E' HEAT SOURCE' <br /> Eaisting Use ot Building 8 ' I ' — <br /> T��� Gas � Electr�c Other <br /> Pwpoecd Usc ol�udding�F—�S�tiC(� <br /> Buil9ing type: �Single Family _Duplex_Townhouse _MNti•Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.L_Sign_Sprinkler_Demolition_Change of Use <br /> Drscriplion ol Work(aedt�onai spnco nrovined on�he bacA): <br /> Have you slarted working withoul.permit7 _YES _NO <br /> MECHANICAL PE RMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: ._ New_Addn Alleration_Repair iYPa of ProJecC ShoweNum6er�(MJ o//i Aureslion_Repalr <br /> Show NumLcr(C)o/fivtums <br /> NC–airhanAlin uni�s i Tn�lel <br /> Forced air s ster.is I Balhtub <br /> � Gas i in Lavalo wash basin <br /> � Walerheater I Shower <br /> � Gas ire lace Kdchen sink 8 dis osal <br /> � Gas ran e � Dishwasher <br /> I Clothes d er Clolhes washer <br /> I Ran e hnoA Water heater <br /> Exhaust fan I Sink�servicelbadmo /etc.l <br /> Heat um I Backflow preveMer <br /> I Unit heater Unnal <br /> Boiler Drmkin Fountain <br /> Relri eralion FloDrdrain <br /> � 1Yoodstovc Grease tra <br /> Dudin. <br /> R�cf drains <br /> Oihor <br /> Medical Gas <br /> SPRINY.LER 1 SUPPRESSION SYSTEM Ouier: <br /> � IJim��br,r n�Heads � OtheC <br /> I lierehy ceridy�hal I have read and er.amined lhis aCPllcation and Fnow Ihe.ame lo ba irue and mrtect.All Drovislons ol laws and ordinances goveming <br /> tt�,�,s rype ol work will 6e complied with whether specilieE hereln or nol.The grantinp al a pertntt Ooes nol D�esume lo give auihority to violate or cancel <br /> Ihe provis�on ot any olher stale or local law repulating consirocllon or the pedormance ol consimctlon.Thal I em aulhorized by lhe owner of thls propEny <br /> !c pedorm�he worN Aor �. * d�� �ion is{ilade nnd I eomply wilh the Slale Contracmrs Law 18.27 RCW and Y96200 WAC <br /> �f � � �/�/Z (Revis¢d 2'20f i) <br /> pwny IAuthoriz� Agent Signature Dale <br /> 1 <br />