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� � <br /> PERMIT APPLICATION <br /> 3UILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St.. Everett, WA 98201 425-257-8810 FAX 425-257-8857 wvrx.everethva.oIrra <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 'l `�b� � <br /> 51� �ES : �, PROOP`E7TV�%�Ij �� ,�O�O�u. U PEHMIT C _O <br /> t� <br /> LEGAL for new mnstmction Snon PiaVsuodivis�on lol No_ (atlach copY ol io�g Iegal Uescr�puon) <br /> OWNER Phone/E�man �� L <br /> Fddres� �j � �l/� � C�Iy/5ta1e21 <br /> APPLICANT: Onne� Owner5A9ent Contre[lor Conlratlof5A9enl Tenanllm�;ipm.ccaim�xrmwme���mmineo..ne��ocawn�nmespace� <br /> CONTRACTO �^ I Lic. p ( COE Bus. Lic.# <br /> Adaress µ P�onclEmad Z <br /> TENANT 8 SIMc�55�IAME NT C♦♦��FO'' R PERM T <br /> /I Phoner �ma�� �•� <br /> BUILDING PERMIT APPLICA i ION CONTRACT PRICE OF WORK W <br /> Existing Use of pwlding HEAT SOURCE�. <br /> Proposed U5e of Butldinq�� Gas_ Eleanr,__ . Olner _ <br /> Bwlding typz�. _Single FamJy _OuoleK_Townhouse _Multi-Family �Commercial <br /> T pe of pro�acC Naw Addition Remodel Repar TJ. Siqn Sprinkler Demoldion Chanqe of Usc <br /> DiSCRIPTIMONOF, WORK(�oerm� n.ilspa�epmvitledonl�e ack). ���I� � /� � � �yy{�����/ <br /> N A I�l.l� I�iCi W Nt7 N O� �Y7�Z?-4� .��`�I'CI.X� �� 7�`�'V I W� <br /> ��rJ s�� <br /> MECHAHICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projecl: _New_Atldn _Alleration_Repair Type ol Project: _New_Addn _AlMralion_Repair <br /> Show Num6ci(p)o!�xfures Show Number(p)o/frxlures <br /> NC—av handlin unAs foilel <br /> Fmced air s stem, Balhtub <br /> Gas piping Lavatory(wash Gzyc�n) <br /> Water healcr Shower <br /> Gas G�e lace Kitchen sink 8 dis osat <br /> Gas range Dishwasher <br /> Ciothes tlryer Clo�hes washer <br /> Ranqe hood Water healer <br /> [xhausl lan Sink(5ervicelbadmoplelc.j <br /> Heat um Backllow reventer <br /> Unit heater Urmal <br /> Boiler Dnnking Fountain <br /> Re6i crahon Floor drain <br /> Woodstovc Grease tra <br /> Ducting Rool drains <br /> Oihcr Metlical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM otner: <br /> Num6er of Heads Other <br /> I nmeby cemty mai I nava read ana e�ammed i�is upD��uilion and Anew ma same to�n we an�cortttt Ai�pmrEions c/laws and ordlnances govem�ng�p,tppe el wo.1 wdi Ee compbe0 <br /> xn�hhet�er spcnGeC heiem or no� ThP�rJI1Lnq OI l D���I40C5�01 p25ullip 10 fJrvC OW�U�N 10 vi0Lll0 0!GlnC01111C pfovi5i00 018ny OIhQf SIJIR 0!bC.11 I.IN�BIjUIdLOd COlI51(16LC� <br /> Thal I am aut�C�zcO Ey Ine ouner ol ma Oroq!ny lo peAorm Ihe woA lor nAich a0G'�Wllon is matle anC I<ompy wnh i�e Slale Conlydclers Law IB 2]RCW a�d 296.YOOA W AC <br /> - �,���. �y <br /> � t odzceAgenlSignalure Date lRevised6?0�2) <br /> \�� <br />