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PERMIT APPLICATION <br /> BUILDING/MECHANIGAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 - 425-257-8810— FAX 425-257-8857—wunv.everethva or <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM ,7 --/�—' I� <br /> SITE AODRESS: //� 7ROPERiYiAXa PERMITp ,1 <br /> "'� �` p/V L� /(/ ^��. <br /> LEGALbrnewconSWCM1on�. Sho�PlaVsubCrvrsron Lo1No_ (attachtopyoflonglegal0esu�plion) <br /> OWNER ,37�� f (� /b o �i jr PhonclE-mail <br /> AdEress •�:a� P //e� i1 � d2 City/SatelZip <br /> CONTRACTOR M 6•�i/S G��t b�o- - L 81 Lic. Y. <br /> Add�ess e.. / ,��_-%� �Zv phonc/Emad <br /> TENAN BUSINESS NAME CONTAC7 POR PERMIT <br /> Phor.ME�mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE oF WORK <br /> Ex�shng Use of Bwlding HEAT SOURCE- <br /> Proposed llse ol Bwltling f,as [lectnc Otner <br /> t3wld�ng lype: _Sirgle Fam�iy �Dup'ex_Townhouse _Mulli�Family _Commercial <br /> TyDe of pro�ecl�. _New _Addition _RemoGel _Repair_T.L_S�gn_Sprmkler_Demo!rt�on_Change ol Use <br /> 005CnpI�On Of WOA(;ad0�'rOnJl Space pNvrdCC on t�e bacN)' <br /> Havc you sWrted working wilhout a permit9 _YES _NO <br /> MECHANICAL PERMIT APPLICATION P�UMBING �CRMIT APPLICATION <br /> Typo of Profect: _New_Addn _Alto�atlon_Ropair ' Typo ol ProJecl: _New_Atldn Iteratlon Ropair <br /> ShowNumba(a)of6rfurcs � ShowNum�er(b)o/lixfurns <br /> A/^-aa hand6ng units Todet T/�G <br /> Forced a�r sys�ems f3aihtab <br /> Gas p�pir.9 �avatory�wash bas�n) <br /> Walcr healer Shoaer <br /> Gas fireplace Kdchca sink 8 dispasal <br /> Gas range pishwasher <br /> Ctolhes dryer Clothes washer <br /> RanGc hood Watcn c�afer <br /> Exhaust fan Sink(serv�ccibadmop/etc) <br /> I Ical pomp packflow prevenler <br /> Umt hcatcr Unnal <br /> �oJrr Urinkin9 I'ountain <br /> Relnqeralion Floor drain <br /> Wo0d5tOVC Gfed50 tf0p <br /> Duct�ng Rool drams <br /> Othcr Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM otner <br /> INumber ol Heads Other <br /> I hereby cerlity Ihat 1 have reaA and erammed�his appl�calion and know ihe same lo�e Irue and coned All pmvisions ol laws an0 ordinances 9ovemmg <br /> th�s type ol work vnll be comphed with whelher specife0 heiein or nol The granting ol a permil does not presume lo give authotlry lo violale or u��cel <br /> Ihe pmvision ol any olher slale or local law regulaling consimction or Ihe pedormance al consWclion.T�al I �m aut�an¢ed by Ihe owner of Ihis pro�e�ry <br /> lo pertorm Ihe work torwhich aOP��calion is made antl I comply with the Slal Contraclors Law 18.27 RCW and 29fi200 WAC <br /> Own� � � �a � <br /> oNzed Agont Signatur Dale (Rev�s^a:?J�t) <br />