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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Sf., Evereti, WA, 98201 -425-257-88 t0- FAX 425-257•8857-vn+nv.everett�va org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM /? � O 6 — /I <br /> SITE AODRE55: VROVCRTY TA%n PERMIT# <br /> w�R oo i a W - �� 3 <br /> LEGAL lor new ce��s!n,c!an�. Shoif P��allsubd�v�sion La1 No. (attach eopy ol long Iegal Jesa,Dtmn) <br /> OWNER }'\� '� LLC Fhonc;E ` t�j Q' ' J� tv� �\t <br /> m��� 4 � o ",� <br /> �,ad«.s a �. � w � ���y,s����,z�P ln. w F� 9g�s <br /> CONTRACTOR � L81Lm. X <br /> ACdress Phore/Email <br /> TE AN�u1N�1�M`1h �- col.kM pr�P �-�-L �J�YrF�ge;�1`1� `����7�g '��� <br /> � <br /> Phoncr[�maJ c �� �C�yn <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Eustn 3 Use of Bw�ding _ NEAT SOURCE. <br /> Pr000sed Use ol Bwld�ng__ ---— Gas Eicanc other_ <br /> Bwiding type _Smge Famdy _DuF.ex_Townhousc _L1N6�Famdy _Ccmmeraal <br /> Type ol proJeG. _New _Addition _Remodel _Repa�r_TJ._Sign_Sprmkler_Demol�tion_Change of Use <br /> Desenption of Wark(ad✓nona!space F�+��ed on trte Oa:K/: <br /> U�/�w ��`7/�`l <br /> Have you started working without a permit7 _YES _NO <br /> MECHANICAL PERMIT APPLiCATION PLUMBING PERMIT APPLICATION <br /> Typo ol Pro�uct: _Naw_Addn _AIMra�mn_Repalr Type o�ProJecl: _Now_Addn �Alteratlon_Ropnir <br /> Show Number(M1 of liaNres Sbow Numbcr(a)ol lixNres <br /> ArC–a�r handhnq units Todet <br /> Forced mr s stems Bathtub <br /> Gas p�pmg Lavatory (�+ash 6asin) <br /> WaICr 1e3kr Shov;er <br /> Gas fireplace N�Ichen smk S d�sposal <br /> Gas rangc D�shwa;hcr <br /> Clothes drver C!othes w�asher <br /> Ranqr.houd Water heater <br /> [ahaust fan Smk(sr.ro�c;e�badmopletc.) <br /> Ilcat pump dack0ow preventer <br /> Uml hcatcr Urmal <br /> f3o�lcr Drinking Pounlain <br /> Rc�r�acration Floor drain <br /> Woodslovc Grease trap <br /> Dudinq Roof drains <br /> Olhcr Mediwl Gas <br /> I SPRINKLER I SUPPRESSION SYSTEM Otner <br /> Number of Heads I Other <br /> I hereby ceNty Iha�I have read anG examinetl I�is appiication and know Ihe same to�e We and cortecl.All provisions o�laws and ordinances go�em!rg <br /> Ihis type o(work will be complie0 with whelher specified herein or not fhe�ronting ol a permit does aot presume to grve authonty Io violalo or wncel <br /> Ihe provison ol any o;her siate or lowl law reguialing conslruction or the peAomiance ol wnstructicn. That I am autlionzed by;he o���er ol Ihis propeuy <br /> 1 ertc fhe woik lor w�ich apphwlion is made ana I compl wilh I�e Slale C nt�a ors Law 18 27 RC�Y anU 29G 200 N'AC <br /> Y� <br /> ';;N.•. ��✓ �t.t�Dir S (I l/ � <br /> Ow� rlAulhori�d Agent Signalura D Ic (Rev�sco:�^07 iJ � <br />