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�- c <br /> IT APPLICATION <br /> BUILD GIMECHANICAU UMBINGISIGNISPRINKLER/DEMOLITION <br /> C F EVERETT PERMIT SERVICES <br /> 320 e t, WA 98201 -425-257-8810—FAX 425-257-8857—www.evere .org <br /> � APPLICATION3 ARE ACCEP7ED FROM 8 AM TO 4 PM �I ��'J / <br /> SITEADORESS: PROPERTYTA%p P �T�/D�—(�S/ <br /> LEGAL for new conslruclion: ShoA PlaVsubdlvision Lol No._ (altach copy of lonp legal desctiplion) <br /> OWNER PhonelE-mail �S a.5 S <br /> Address Q CIIy/51a1e21p <br /> CONTRACTOR L&1 Lia# <br /> Address PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT/�� O/S�� <br /> IJ <br /> Se,/Q YIC�Q � Phone/E-mail aS' s ' <br /> BUILDING PERMIT A LICATION CONTRACT PRICE OF WORK <br /> Ersting Use oi Building C o—�—e_ HEAT SOURCE: <br /> Proposed Use of Building Gas_ Eleclric Olher <br /> Building type: _Single Family _Duplex_Townhouse _Multi•Family _Commercial <br /> Type of projecl: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolilion_Change af Usa <br /> Description oi Work(addifional space provfded on Ihe back): <br /> ��moJ-e ¢ l�O�a�2, /�UD�'`�p f��/l�- G( '�n"� <br /> ( � <br /> Have you staAed working wfthout a pertnit9 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProjacl: _New_Addn _Alteration_Repalr Typoof ProJoct: _New_Addn _Alteratlon_Repeir <br /> Show Num6er(NJ ol Itxtures Show Num6er(MJ o/Rxtuns <br /> A/C—airhandlin units Toilet <br /> Foroed air systems Bathlub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&dis osal <br /> Gas range Dishwasher <br /> Clolhes d er C�othes washer <br /> Range hood Water heater <br /> Exhaust(an � Sink(service/barlmo lelc. <br /> Heal pum 8ack0ow reventer <br /> Unit heater Urinal <br /> Boi�er Drinkin Founlain <br /> Refri erelion Floordrain <br /> Woodstove Grease tra <br /> Duclin Roof Arains <br /> Other Medical Gas <br /> SPRpNKLER!SUPPRESSION SYSTEM Other. <br /> Number of Heads Olher. <br /> I hereby cehify lha:I have read and eKamiied this epplication and know Ihe same to be truo and cortecl.AII provisions of laws and ordinances Boveming <br /> this lype of work xall 6e complied wi�h whe".her specffied herein or not.The granling of a permit does not presume lo glve aulhority�o violate or cancel <br /> Ihe pmvlsion of anY oth^r slale or lowl�aw regulating consWclion or Ihe pedormance of conslruclion.Thal I am authorized by Ihe vwner of lhis piopeAy <br /> fo peAortn Ihe wod:lor which applicallon�s made and I wmpty wilh the Sla�e Coniradors Law 18.27 RCW and 298200 WAC <br /> l�� <br /> OwnerlAuthori[ed Agent Signature Dale (Revised 2/20f 7) <br />