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� ! <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERE iT PFRMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �-a.3 '�L� <br /> SITE ADDRESS; PROPER7YTAXN PER = _ <br /> f <br /> LEGAL tor new construction: Short PlaVsubdivisio Lot No._ (attach wpy ol long legal description) <br /> OWNER � PhonelE•meil � <br /> Address CIIyl5late/Zip /' r� �G <br /> CONTRACTOR (J ' � E� L 8 I Lic.# � [� / <br /> Address PhonelEmall � % T 7 f� O <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ���°C �'�(� �Q S W«��S �� PhonelE-mail <br /> BUILDING PERMIT APPLICATION CON7w►cr PRICE oF WORK <br /> Existing Use ot Building �/ � /� <br /> HEAT SOURCE: <br /> Proposed Use of Buildinq �Y �y 2��N /`l�A `-5/"/OD Gas_ Elxctdc_ Olher_ <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family�Commercial <br /> Type of projecl: �New _Addilion _Remodel _Repair_T.I._ Ign_Sprinkler_Demoiition_Change of Use <br /> Descriplion of WOrk(additional space provided on the back): <br /> Have you slarted working wfthout a permit4 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa of ProJoct: _New_Addn _Alteratlon_Repalr Type of ProJect: _New_Addn _Alteralion_Repelr <br /> Show Number(8)oI Rxtures Show Namber(M)ol!lxtures <br /> AIC-airhandlin units Toilet <br /> Forced air systems Bathtub <br /> Gas pipin Lavato (wash basin <br /> Water heater Shower <br /> Gas fireplace Kilchen sink 8 disposal <br /> Gas renge Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan � Sink(service/bar/mop/etc.) <br /> Heal pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eralion Fioordrain <br /> Woodstove Grease tra <br /> Duclin Roof drains <br /> Olher Medicat Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. <br /> Number of Hezds Olher: <br /> I hereby certify lhat I hava read and examined Ihls applfcallon and know lhe seme to be In�o and wrtecl.All provisions ol laws and ordinances gaveming <br /> this lype of work will bo compiled with whether specified herein or�ot.Tho granling ol a permil does nol presume lo give authci�y to vlolata or cancel <br /> the provision of any olher slate or local law re9ulating conslrucllon or the peRormance ol cons�ructlon.That I am aulhorized by lhe owner ol this property <br /> lo peAorm Ihe work for which application Is made and I comply wilh Ihe Stata Contractors Law 18.27 RCW and 298.200 WAC <br /> / <br /> �n��r:�� ��r 4�/4 �' (Revised Yt011) <br /> OwnerlAuthorized Agent Sfgnature Date <br />