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PERMIT APPLICAT'ION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERNIT SERVICES <br /> 320D Cedar St., Everett, WA 98201 - 425-257-8810- FAX 425-257-8857-vn��nv.everethva.org / / <br /> APPLICATIONS ARE ACCEPTED FROM 8 A�d T04 PM �2 —(9— ( <br /> S;TE tiDRES�� � � PROP[R1Y�I(� ��� M T# ' � <br /> LEGAL!ar ne�v consln:c'�on� Sh;rl PiaPsubC�vis��en Lot No (altach copy cl iong legal C^scription) <br /> OWNER '�'� �l. Phone![�maJ �I� S �� a�j <br /> Aaa«,5 �� a��- S�- � ��.r,5,�,�,�,P � upm a� � <br /> CONTRACTOR � L 4 I Lic. # <br /> .�OOres, Phonc;Emad <br /> TENANT BUSINESS�iA C NTACT FOR PERMI f', Op� '�Qr-� <br /> �y a 5 0 �_�Jy <br /> �r��� �rtUe�n . -�-Cc�by prOp LI.L ������"���F�er�'�e.. � �o �cam <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> ExisLng Use of�wldmg HEAT SOURCE <br /> Proposed Use of 6u�iding Gas Etectric Olher <br /> Bwldmg type�. _Smgle Famdy _Duplex_Tov:nhouse _tduili�Family _Commeraal <br /> Type of pro�ed� _New _AddiUon _Remodel _Repair_T I._S��gn_Sprirk;er_Demol�t�on_Channe of Use <br /> Uescnption of Wotk(ada,honal,Foce pm�,Ced on tne ea:e): <br /> Jdi /N.�,.�/ /Lv�"tl� J <br /> Havc you slarted working without a permit7 _YES _NO � � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> iypo ol Pro�etl: _Now_AdEn _AltCraUon_Repa�r Typo ot Pro�ecU _Now_Addn _AllcraUon_Ropafr <br /> Show Num6er(M)of lixfures Sbow NumDer j nJ ol lirfums <br /> �VC–au handling units Toilet <br /> Forced a�r systems �athtub <br /> Gas pipm Lava:ory(v:ash 6asinl <br /> Waler heatM Shower <br /> Gas GreplaCe Kilchen s�nk 8 disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clot�?s washer <br /> Range hood Water heater <br /> Gxhaust I:m Sink(service�bar/me�'elcJ <br /> Hea�Vump 13ackflo��v Vreventer <br /> Unil healer Unnal <br /> Bodcr Dnnkmy Founl;un <br /> Rc'ngeraLon Floor diam <br /> Woodstove Grease trap <br /> Duclinq Rool drains <br /> Other Med�wlGas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Num6er of Heads Other. <br /> I iie�eby certity thal I have mad and ezammed Ihis applicahon and know Ihe same lu be true and conecl.A!I provisions ol laws and orAmances 9oveming <br /> this lype ol wonc will 6e camphetl rnlh whclher spetified hereln or not. The granimg ol a permn Aoes nol p�esume lo grve authonty Io violaie or canccl <br /> Ihe pwvlsion ol any ot�er slate or lowl law regWaiing consWcUon or I�e pedormance ot conslmct�on.Thal I am authonmd Uy ihe owner of Ihis propetly <br /> to peAorm Ihe work lo�which appiicallon is maCe an�I cemply wi�h Ihe Stale Conira lors Law 1 B27 RCW and 296 200 V✓AC <br /> i1 //, 1!� <br /> �_ _�f h.��,.�� , .,C� M.�� �t �I 1 1 1� <br /> Ownedn�thorizeJAgc�lure D, e (Rev�sedS0lt) <br />