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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 �nnvw.everettv✓a.org <br /> SITE ADDRESS: PpOFENTY TnX N PERMIT <br /> .� _ cr� v� - D`i5 <br /> LEGAL for new construcl�on: Short PlaVsu6Civision Lol No (altach copy ol lon9 legal description) <br /> OWNER rtesian � e � PhonelE�mail <br /> Address City/Slate/Zip <br /> APPLICANT:_Owner _OvmersAgem _Contractor _Contradofsn9ent _7enantim.�v;�o��ceamix�oic��,�-ic�.r,eo�r�r��aowon�,m�so�cu� <br /> CONTRACTOR �(//�L/ T Slate Lic# City Bus. Lic. # <br /> Address Q S (/ E`" P�onelEmal <br /> TENANT BUSWE55 NAME Srfie f i n e� CONTACT FOR PERMIT �/GC �L J��T <br /> PhonelE-mad ��� 7J�y �7� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Ezisbng Use of Bmlding `�7�' HEAT SOURCE: <br /> Proposed Use of Bwiding �/r/�/T Gas_ Eieclric__ _ O�her_ <br /> 6udding type. _Single Fam�ly _Cuplex_Townhouse _Multi-Family �ommercial <br /> T�pe of pro�ecC Nevr Addition emodel Repair�_Sign_Sprinkler__�emolition_Change of Use <br /> D ES C R I PTI ON O F W OR K(;dd eer m spaee pro��eed on me back). <br /> Z r�f�.� �� ►`t� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ot Prqect: _New_Addn _Alteration_Repair Typo of Project: _New_Addn _Alloration_Repair <br /> Show Num6er(q)o(lixlures Show Number(tt)o/lixlurrs <br /> A7C—air hantlling units � Toilet <br /> � Forced air syslems i Bathtub <br /> / � Gas pipmg � Lavatory(wash basin) <br /> � Water heater Shov+er <br /> I Gas fireplace � Kitchen sink &disposal <br /> I Gas rangc I Dishwasher <br /> I Clolhes dryer � Clolhes washer <br /> Range hood � Waler heater <br /> Gxhausl fan I Sink(service/badmop/etc) <br /> Heal pump E3ackflow prevenler <br /> Unit heater Urinal <br /> Boiler i Drinking Fo�nla�n <br /> � Refr:9era�ion � Flnor drain <br /> Woodstove Grease trap <br /> Ducling � Roo(drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESS�ON SYSTEM Olher: <br /> Number of Heads � Other. <br /> I�ereEy cenCy I�al I Imve read anC e+amined I�is appliwfion antl know t�e same lo Ge I�ue antl wnen A!I pmvisions ai laws and aCir.arces govemicg I�is type ol woB x91 he camD��eO <br /> wa�whe��er spenlietl�c�mn or not.Tne graming ol a pertM does noi presume io qrve aw�or�y io v:ola;c or cancel I�e D�ovision ol any other sla:e or lowi Ww regW.ting consVuclion � <br /> inat I am a�men:ed�y ihe owner cl i�is pro�e"y Ic pMorm me wort lor v,Tic�aDG!iwlirn�s maae c.�E I cemC�Y w�����e�lale CoNmr.ors Law tB.77 RC W anG 296 200A WAC. \ 2 <br /> '�-�✓�� iil i y/� G�y <br /> OwnerlAuUwrized Agent Signalure Date (Revised 7/1013) <br />