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• ! <br /> PERMIT APPLICATIO�i <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 96201 425-257-8810 FAX 425-257-8857 www.everetteva.org <br /> 2� <br /> SITE ADDRESS: PROPE TY TAX k PERMIT x ^^ <br /> 2 �Z—W� <br /> LEGAL lor new cons�mcfion: hort PlaVsubdivis�o Lot Nv. (allach copy of long legai desviption) <br /> OWNER $i� I'r,p Phone/E�mail <br /> Adtlress CrtylStatelZip <br /> APPLICANT: Ovrner C+mer�'_Conlraelor _CoNraelor'sAgent _Tenanlf��..ice.�oa�en:rc'a:;e::ec�c.ec,�:•i:�a.,c+�.,v��sn:�� <br /> CONTRACTOR T. � 1'� Stale Lia : City Bus. Lia � <br /> AdGress Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �� � � Q� ���,.��� p/ <br /> a <br /> Ki� �ct, E����� ' p , l'-a-n� <br /> � PhonelE-mad �/� 6D�7_ <br /> BUILD G PERMIT APPLICATION CONTRACT PRICE OF WORK ,I' ea'o -- <br /> ExisUng Use of Buildmg �C/t, FIEAT SOURCE�. <br /> Proposed Use of Building�_J��Q(�g� . � � • — <br /> Gas Eiectric___ Other_ <br /> Bwltling type: _Single Family _Duplex_Tovrnhouse _MWfi-Family �Commerci;l <br /> Type of projecC New Addi�ion Remodel Repair_ T.I. _Sign_Sprinkler_Demohtion_Change of Use <br /> DESCRIPT,!ION OF WORK(addrt�ona�space.}p-�ovided on ma 6ack). / / ` <br /> �jrrr"/i`�� �e.��vrn/v� a2/;.r:o-r' /��•n,UaU+.( �o o1Lf'cK.=ar� Gev� �3E�u.�%x..�¢.L _ <br /> � ,�,[ (/ U <br /> iC(�``��/Y'�/ -Q,. �S�2Gl.f �� , ./�'1"2�� . <br /> MECHANICAL PEFtMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: _Nuw_Addn _Alleration_Repair Typo ol Pro�ect: _New_Atldn _Alloralion_Ropair <br /> Show Numbc�(N)o/lixfuics Show Numbrr(N)o//ixfures <br /> A/C-air handling unils I � Toilet <br /> � Forced air systems [3athlub _ <br /> Gas piping Lavalory(wash basinj _ <br /> � Water heater Shower <br /> Gas freplace Kitchen sink 8 disposal <br /> Gasrange Dishwasher <br /> � Clothes dryer I CloUres washer <br /> Range hood � Walen c�ater <br /> Exhaust fan Sink (servicelbar/mople�c) <br /> Hcat pump � Backflow preventer <br /> Und heater � Urinal <br /> � Boiler Drinking Fountain <br /> Re(rigeration � Floordrain <br /> Woodstove Grease trap <br /> Ducling Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRE�SION SYSTEM O�her <br /> NumberofHeads � Olher <br /> I�ereby ceroty mat I have ieaC antl eaammed Ihis�pPLcalion and Fnow Ine same lo Ce Ime ond correct.All F�ovisens ol laws and cra:nances goveming Ihis lype ol work�.vill Ee comp':etl <br /> wM1�xnei�er specNed nerem or nol.7�0 9ranting ol a pertnit Coes not O�esuma lo eivo aw�orrty to v�oialo cr cancel I�e provis:on ol any olher.tato ar local ta�rv regulating consw<Iwn <br /> T�al 1 am aul�onZed Dy Ine owner 01IIfi5 pfOpetly l0 petl0lm It1e Kofk I0f wMtlt eppliCalion IS mdCe�na I[omply x�11 t�C 5191e COniratlo�s Law 18 27 RCW an0 29G 200A N'FC 1� <br /> �- - (�-/`Z 2�/ � <br /> ` v <br /> OwnedAuthorizod Agenl Signaturo Dale (Rewsed:U1013) <br />