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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMSING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St . Everefl. WA 98201 -42`-257-8810-- FAX 425-257-885i -wwv�everettwa org <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM — I O "I� <br /> SITEADCRESS:� � / � o J/ PROPENTVTN(u PERNiip <br /> l CJ Q — <br /> LEGAL lut new tcr,st�uci�o� S�otl PtaL'aW�rv 5:on Lol No _ �anach eocr of long ie�al Eesu�cuoc� <br /> OWNER. 7 p G ��7��'� GL C— PnorNE�maA <br /> M1O�ress � !/ � i/!�- � /� C y;-!ale/Zip <br /> CONTRACTOR �/� p.� I� �p �� I. E I I ic A <br /> /<ad�C55 a n s / 7/ � �6 Pnone.'Enatl <br /> TENAN BUSIN.E55 NAME CON?ACT FOR PERMIT <br /> Ph�^.c,E-^ail <br /> BUILDING PEft�J11T APPLIC/1T10N CONiRACT PRiCE OF WORK <br /> Er st ny Use c1 Bm�.r.g_____ __ _ HEF,7 S^URrF <br /> Proposed Use o!Owldmg Ga; E�a_.r�c O:ne� <br /> �udOmgtypr _SingleFamllr _DupleK_To+mhouse _Mutti-Fam�iy _Commerual <br /> Type of pro;ect _New _ACC,tion _RemoOel _Repai�_Y.1._Sign_Sprinkler_Ocmo6ticn_Char�e of Use <br /> Descnptio�ot VJork lzo:�;:onzi saaceG�onCeaon the 6eck)� <br /> Have you slarted working without a permil7 _YES __NO <br /> MECMANICAI PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol ProjocC _Naw_Addn _Albratlon_Ropalr Type oi P�oJoct: _New_Adtln �Altcrallon epai� <br /> ShowNu�nbrr(M)ol4rfures h wNumbwlplol/iafums <br /> A�C-air hano;�^g c^ds Toilr� <br /> Forced air sps'urns f3atttub <br /> Gas ci,�^a � Lavatcry(wash basni! <br /> water reater Sho�ner <br /> Gas tiPpiace K�td,^_n smk 8 disposal <br /> Gasrange Uishwasher <br /> Clolhes tl er Ctothes wa�ner <br /> Rangc hood Water heater <br /> E�haust lan Sink Isernar�l:a�/mop�ete) <br /> Hcat p�mp f3acklww pievrnter <br /> Uni1 heat=r L'nnal <br /> ftoiler Dnnr�ng Fouma��> <br /> Re!ngerat�on Fl7or C:am <br /> lNood�tove Grease Irap <br /> Ductinq Hoof d;ams <br /> Other Med�cal Gas <br /> SPRINKI.ER I SUPPRESSION SYSTEM Other <br /> � Numb=rolHeatls Other <br /> I he�eby cetl�ty Ihal 1 have read and eRammed I�is aDO���lmn anU kr,Dw IAe 5am0 to GC 1Ne antl cOrted All proviswns ol laws and ordmances pmemmq <br /> Ihis type ol work wrll be comphe0 wilh whr.l�er s0eci6ed heiem or nol.The granhng ot a permil tices nol presume to g��e au'horrty to violale oi�inccl <br /> Ihe prov�sien ol anY olher siale a bwl iawceguialmg construc6on or Ihe pedormenct ol consVuctian. ihal 1 am aulnonzed 6y Ihe ownei al lhis p��q,crty <br /> lo prdorm ihe wo�t�u v,n��.h aCp�.eauon�s made an0l compty wi�n Ihe 51 e Contractors Law IB 27 RCW and 298 200 WAC <br /> �� � . .��� 3/�� �/ <br /> AutAorizetl Agonl Sig tur�ie c �— La�� (/'r.u�d<<<"'��1 <br />