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r <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBING/SIGNISPRINKLER/DEIVIOLITION <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 8 AM TO 1 PM ol / /Z <br /> SITEADDR .I/ VIIOiER7YTAX11 PERMITR <br /> t(// a GbZ 5 <br /> LEGAL lor new construdlon: Short PIaV�ubEivl n Lot No._ (attach copy of bnp kpal Oefaipllon) <br /> OVYNER � Ptwne/E-mali <br /> aaress cmrs�aie�z�o e� ' �/ �� <br /> CONTRACTOR /�/ f- L 8 I Lia lt <br /> ddress PhonUEmail <br /> 7ENAN7 BUSI S NAME CONTACT FOR PERMIT <br /> / '/ � Ptwne/E-mall �� � �/ C�•F.�aI��/ '��\;� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK U <br /> Existing Use oi Bui�din8 HEAT SOURCE: <br /> Pmposed Use of Building 1,�NL F �as eieario Otner <br /> Building type: _Single Family�D�x_Townhouse Multi-Family _Commercial <br /> Type of proJect: _New _Addition Remodel _Repair_T.I._Sign_Sprinkier_Demoittion_Change ol Use <br /> Descriplion ol Work(atlditbnal space provltled on fhe backi: <br /> Mave you atarted working without a permit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMRIING PERMIT APPLICATION <br /> TypeolProJect: _New_AtlAn�Alteratlon_Repalr TypaofProJect: _New_Addn _Ak�ntion_Repelr <br /> Show Number(I)ol flYfurca SM1ow Number(NJ ol flxfuni <br /> A/C-airhandlin units Toilel <br /> Forcedairs slems Bathtub <br /> I Gas ipin Levato wash basin <br /> � Water heatei Shower <br /> as fire lace Kitchen sink 8 dis osal <br /> as r e Dishwasher <br /> Clothesd er Cbtheswasher <br /> Ran e hood Water heater <br /> Echaust fan Sink service/bar/mo /etc. <br /> Heat um 8ackflow reventer <br /> Unit hea�er Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floordrain <br /> 1h'oodstove Grease tre <br /> � Dudin Roof drains <br /> � Other Medical Gas <br /> SPRINKLER/SUPPR[SSION SYSTEM I other: <br /> Number of Heads I Other: <br /> I hereby certiy Ihat I have read and examined Ihis eppliwllon and know Ihe same to be Irue end correcl.All provislons ol l¢vis and ord�nancea poveming <br /> t�is ryDe ol work wiil be complied wilh whether spcclfied hereln or not.The p2nting of a permit dcea not presume to pive eulhority to violete w cancel <br /> the provislon ol any ot r atate or local law repulaling construdlon or the perlormance ol consWqion.That I am aut�otlzetl by the owner of�his pmperty <br /> to rtorm ihe work t which applicetion Is made and I ompy with Oie Stste Contradon taw 18.27 RCW enA 288.20o WAC <br /> O nerlAuth AzedAgentSgnaWre a �/��p� (Revixd7/Y01f� <br />