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. � c <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., E�•ereri,WA 98201 -425-257-8810—FAX 425-257-8857—wuvw.everettwa.org <br /> APPLICAT10N3 ARE ACCEPTED FROM E AM TO 4 PM I`"I Z <br /> SITEADDkE33:�I8 � £� �` � PRO��nxM�� lol PeRMR• <br /> � <br /> I.EGAL Ior new wnsirudlon: Snort PlaVsubdivislon Lot No._ (atlach copy ollonp leqal desuipNon) <br /> D��1���0� ,�1.��'!1� d- AS�� �« PhonelE•mail '/ c} <br /> ddress(Yi0 �G4S 7� J'E �clv CiylStatelZip SR4.'�Tf'e w� 1eIC� <br /> CONTRACTORM �S S� .�% �v+.'s�k �aiva,r e -er5Ao3�4� <br /> ddress�b� E�w �Q �h �W���`+�"� ����3 PhonelEmail�-�11�/-�3ZS ��I e��r�f5� u- �'"t <br /> TENAN1TnBUS1I�]NES N-1AME �,D N � � iI� I�YvG <br /> ��{[X Y�l {us �.1��`��`� PhonelEmall 3GU'�IZY'�ZS� ��� � �CS�SI .CO W <br /> BUILDINGPERMITAPPLICATION CONTRACTPRICEOFWORK �lvv <br /> Ezisting Us^oF BuiWing �Oi IC� �JUTM�`t5 HEAT SOURCE: <br /> Proposed Use af BuiMing b<<� S�A ���� Gas Eiectric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi•Family _Commarcial <br /> Type ot projed: _New _Addition _Remodel _F.epair_T.I.�Sign_Sprinkler_Demolition_Change ot Use <br /> Desuiplion of Wofk/addifional space pronvided on fhe ba1ck):,A 1' <br /> �CV��utJe 'T�n"� lSG`�yn54yN1 e�c�5"�`Lk{ l.a�LM Slt�L1 . <br /> V u <br /> Haw you started workinp wlthout�psrmlt4 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PEkMIT APPLICATION <br /> ryp�of ProJecL' _H�w_Addn _AlNratlon_R�pdr Typs of ProJkt: _IMw�AAn _Albntlon_R�p�lr <br /> S�owNumMrM/offlduros ShowNumMr )o/fl+tunf <br /> AIC—airhandlin units Toilel <br /> Forced air s slems Bathlub <br /> Gas i in Lavalo wash basin <br /> Waler heater Shower <br /> Gas fire lace Kilchen sink 8 dis sat <br /> Gasran e Dishwasher <br /> Clolhes d er Clothes washer <br /> Ran e hood Water heater <br /> Ezhaust fan Sink servicelber/mo letc. <br /> Heal um Back9ow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Rehi eretion Floordrain <br /> Woodstove Grease tra <br /> Ductin Roof drelns <br /> Other Medical Gas <br /> SPRINKLER/ 8UPPRE8310N SYSTEM Other: <br /> Number af Heads Olher. <br /> I hereby certity Ihat I have read and e%amined Ihis appliwlion anC know ihe same to be Vue and corteel.All provisbns of laws and ordinances poveminp <br /> ihis type ol work will 6e wmplied with whel�er specified herein or not.The B�ntinp ol a pertnit dces nol presume to give auMoriry lo vblete or cancel <br /> the provision of any other state or local law regulating cansiruction or lhe pe�formance o1 consWction.Ttiat 1 am aut�orized hy�he owner of thh property <br /> to pedorm t�e work lor vA�ich appliwlion is made and I comply wilh the Stale Contreclon Law 18.27 RCW and 298.200 WAC <br /> 1(�)` � �(—(c�—l '� <br /> 1±�L���� (Revised 7/POf il <br /> OwnaNAutlwrlxM �ntSlqnaWn Date <br /> l�Z <br />