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PERMIT �PPLICATION <br /> BUILDINGIMECHANICALIPLUM131NGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT 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 <br /> . PROPERN TAXp ��M��tt(�I -OO <br /> • s(azl� � vCeC;��z�en� .a• <br /> LEGAL for new construclion: Short PlaVsubdivislon Lot No._ (allach copy of long legal descnption) <br /> OWNER [ "Z .,�1 ATO�� TON'� PhonelE-mail 2.5- C� _ v7 ?j <br /> - C� <br /> address 5 Z(�� ��/C" '�('��zc° =n/ V'�i�' Cily/SlalelZip C-V�R.cTT VJ� � Zv3 <br /> CONTRACTOR 7 S(�i1vUG ' .��r ��2 S L&I Lic.# 7SLC� G�= Oi v� A <br /> Addre�s o ZS 7`i I���c�� �� �^« Phone/Email ZS3•- 40� • 7A75 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> E ot�:r.ic;� TA i i��; PhonefE-mail 'L`7 3� �105 - 7�9� <br /> BUILDING PERMIT APPUCATION cONTRACT PRICE oF WORK / �GC. G'G <br /> HEAT SOURCE: <br /> Existing Use of Building — <br /> Proposed Use of Building Gas_ Eiearic_ Other__ <br /> Building type: _Single Family _Duplex_Townhouse _Multi•Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demol(tion�Change o!Use <br /> Description of Work(adaifional space proviCed on fhe back): <br /> ��LcCA't2C��J Ui Cn1S h`1i=TC R- <br /> Have you staAed workfnc�without a permit? _YES _NO <br /> MECHAiJICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo af ProJoct: _Now_Addn _Altorallon_Rapair Typo of ProJect: _Now_Addn _Altcratlon_Rcpatr <br /> Show Numbcr(#)o/lixfures Show Number(N)o/(lxfures <br /> � A/C-airhandlingunils _ � Toilet <br /> Forced air syslems _ � Balhtub <br /> Gas piping ._ I Lavalory{wash basin) <br /> Water heater _ Shower <br /> Gas fireplace _ Kitchen sink&disposal <br /> � Gas range _ Dishwasher <br /> Clolhes dryer ._ � Clolhes washer <br /> ` ' Range hood _ Water healer <br /> - Exhaust fan _ Sink(service/bar/mop/elc.) <br /> � Heat pump _ � Back(low preventer <br /> Unit heater _ � Urinal <br /> Boiler _ ( �rinking FourAain <br /> Refrigeration _ Floor drain <br /> Woodstove _ Grease trap <br /> Ducting _ Roof drains <br /> � Other _ � Medir,al Gas <br /> SPRINKLER I SUPPRESSION SYSTEM _, I Other <br /> Num6er ol Heads — <br /> I hereby certify that I have read and examined this application and know the same to be true and mrrecL All provislons of laws and ordinances goveming <br /> this type of v+ork will be complied�vilh whelher specified herein or not.The granling of a permil does not presume to give authonry Io violate or cancel <br /> the pmvision o(any other slate or local la�v regulating consWction or the pedormance of consiruclion.Tha�I am authorized by Ihe owner of lhis pmpeAy <br /> lo pedorin Ihe work for vihich applicatioq is made and I comply wi�h the Slale Conlrac�ors Law 18.27 RCW and 296200 WAC <br /> � � . ; <br /> / �����•.� � ����� <br /> ( Da�e (Revised 7Y20 f 0J <br /> Ownerjp thor zed Agont Sigraturo <br />