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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVEkETT PERMIT SERVICES <br /> 3200 Cedar St , [verett, WA 98201 - 425-257-8810- FAX 425-257-8857 -wvnv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM 7`- �Z -II <br /> SITEA�DRE55: 3yZ� � J� PNOPERTVTA%tl PERMITC � _p2 <br /> 7 <br /> LEGAL lor ne.v conslruehon� Snoh PlaVsu6d�wsmn Lol No._ (alta[h eopy o}long Icgal Cc,enptlon) <br /> OWNER e Q✓'� Phone/E�mad 4�5 � ��ib�� K�, nr7 <br /> aae�ess �7riHL1 U,til:, Kc �� t�1E CJy/S1ateQip ��i � �(�e WA `1�340 <br /> CONTRACTOR JcNt ui L& ILictF �i g'�9 D <br /> 3� r� � 5�, 5� a � ��� �� — <br /> address 1� LI� �. W '�t�e "i/�i� �noneiEmad Q 7S <br /> TENANT BLSINESS NAME CONTAICT{1F� O/R� PE`RMIT ,nT <br /> r [�VY�P ` C✓W(/ I'MJC�%W\ ���C" XI�J�. CV^^� <br /> 7��1Mi`� �p�-��St�a Phone�E•ma�l 7ct_, 2?it-1 7U��} <br /> BUILDING PERMIT APPLICATION CON7RACT PRICE oF woRK ��-vUU `o <br /> E*��stmg Use of Bwld�ng �an'�:5� HEAT SOURCE <br /> ProposedUseofBWltling �wMt� Gas Eleclnc_ Otner__ <br /> Bu4ding lype _Single Famdy _Duplex_Townhouse _MuIlrFamdy �Commercial <br /> Type of pro�ect _New _Atltldlon _Remodel �C Repair_T 1._Sign_�ennkler_Demo�ihon_Change of Use <br /> Descr�p;ion o(Work(ada�r;onal space prov.tled on 1ne 6acFJ�. �l � �;,�� <br /> �P�;� CcT� '�vH�. �nn�v S�cI <br /> �-_- '--_ <br /> Have you startcd working without a permit7 �YES�_NO 0��5„��� a � c°- 5���P `��� �n� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPUCATION <br /> Type ol ProjecC _New_Addn _Alteraiion_Repair iype of PraJect: _New_Addn _Alteration_Repair <br /> Show Numbrr(a)o!/ufines Show Namber(a)01 hxfures <br /> AlC -uir handbng umis � Todel <br /> Forced a�r syslems �alhtu6 <br /> Gas p�n�ng Lavatory(wash basin) <br /> � Waler heater Shawer <br /> Gas Greplace Kdchen sink&tlisposal <br /> Gas ranpe Dishwasher <br /> Clothes dryer Clalhes washer <br /> Rangc hood Watcr hea�er <br /> Exhaust fan Sink(scrviceibar/moplelc ) <br /> Heal pump � flar.kllow preventer <br /> Und nealer Unnal <br /> Bodcr Unnkmg Fountam <br /> ReRiacration Floor drain <br /> Woodstove Grease Irap <br /> Dutung Rooftlrains <br /> Other Med¢al Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other <br /> NumberoFHeaas Olher <br /> I hereUY�erLry Ihat I have reatl antl examined Ihis aOPhcatwn anU Anow Ihe same to�e Ime and cerretl.All pmvisions ol laws and orA�nances govem�ng <br /> �Ns ry0e ol work will�e compl�etl wnh whether specifed herein ar nol. The grantmg ol a permd tloes nol presume to give aulhonly lo v:eiate er cancei <br /> Ihe prov�s�on ol any olner state or lowl law regula0ng conslmclion or Ihe pedormance ol can,��uctroa 7na1 I am authonzed�y Ine owner of In�s p�operty <br /> to perfo Ihe woik lor whlc�apphcaeon is made and I comply wllh Ihe Stale Conlracbrs law 18 27 RCW and 296.200 WAC <br /> �7����/( <br /> nedAulhorized Agenl Signature � Datc (Rer�sed Z7017) <br />