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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereti, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: y�` �Q // PROPERiYTA%p P RMITft�Iu,3 _LG i <br /> b <br /> LEGAL for new construc�iore Shorl PlaVsubdivislon Lol Na_ (atlach copy of long Iegal tlescription) <br /> OWNER �/{+� C✓l/ � Phone/E-mail <br /> Address Cily/StalelZip <br /> CONTRACTOR C«'�' d� �� ` S L 8 I Lia# <br /> � �� y/ � ,,,,•!`'— e�Yy Phone/Email <br /> Address � E ,. 1- � s� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelF�mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use ot 6uilding HEAT SOUftCE: <br /> PropOsed Use of Building Gas_ Electric Other_ <br /> Buildingtype: _SingleFamily _Duplex_Townhouse __Multi-Famiiy _Commercial <br /> Type of project: _New _Addition _Remodel _ReHair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Descriplion o(Work(additionel�pace provided on fhe 6acN : � � h �/ G� `,L+ /.�.��,�„h �j l..� � <br /> 7' (if✓/�1 �v'S�l � C✓�T f �n �as �T �� <br /> w � <br /> ` f -7'o r <br /> l �h <br /> Have you slarted workinp without a permit9 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoolProjocl: _New_Addn _Altoratlon_Ropalr 7ypoolProJecl: _New_Addn _Allaratlon_Ropalr <br /> Show Number(b)ol Iixtures Show Num6er(tt)o/Iixfurcs <br /> � A/C-ai�handlmgunils I Toilet - � � /Y <br /> Forced air syslems Bathtub <br /> Gas piping Lavatory(v+ash basin) <br /> Water heater o / + � Shower <br /> Gas freplace Kitchen sink&disposal /i'�.�i <br /> Gas range Dish�vasher <br /> Clolhes dryer � Clothes washer <br /> Range hood VJater heater <br /> Exhaust fan Sink(service/badmo /etc.) <br /> Heat pump � Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting � Root drains <br /> � Other Medical Gas <br /> SPRINKLER I SUPPRES510N SYSTEM I Other: <br /> � Number of Heads I Other: <br /> I hereby certify Ihat I have read and eaamine0 lhis applicatiou and know iha same lo be true and cortect.All prcvisions of�aws and ordinances goveming <br /> Ihis rypo of work will be complied wi�h whelher specified herein or not.Tho graNing of a permil tloes nol presume to give aulhority to violate or wncel <br /> Ihe provision of any olhet slale or local law regulaling canslructlon or Iho performanco oi conslmction.Thal I am aul�orized by the owner of fhis property <br /> to pedormJ Ihe work for which application Ie made and 1 comply wilh Ihe Stale Coniractors Law 7827 RCW and 296200 WAC <br /> / ' ^ �7 ...�� �J ., �I�I �7��/ <br /> � : " (. <br /> � � (ReviseC22071) <br /> Owner/M thorizod Agont Signaluro Dale <br />