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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <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 /> SITE ADDRESS: PROPERiY TAX M PERMIY q <br /> - rz � w 5�00 <br /> LEGAL lor new consWdion: Short PlaVsubdwision Lot No._ (allach copy ul long legal desc+iption) <br /> OWNER ��Tc.. �(�Pu� PhonrJE�ma�i <br /> Addir.ss CitylSlate/Lp <br /> APPLICANT:_Onner _�wnefsAgent CaNraclor ✓cn�nclofsAgent _Tenanl�mvvpu+acaknroimn:emrtcmmem.nniodo.wwinmeco.�m� <br /> CONTRACTOR ��f �c.4c. L 8 I Lic.# O�o y b-o o GOE Bus.Lic.# <br /> nddress �3 At.oR.�ut �uR 4 zz PhonelEmail 36p.�pY_'IS79 ��E+�Qwest 1 .^+r <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT wM OR- '��-G.k� �l1�oMo-S <br /> J0o ���4��tmfG ol.f`ef 3�o -'teY--tsv9 <br /> 0��� (�(� Pnor,dE-mail �n�p I SY/.�.�,C.�oAl,l . M1l'� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORN I5, 0 7 �. . �{8 <br /> Ezisling Use of Building HEAT SOURCE: <br /> Pioposed Use of Building _ Gas_ Eiectnc_ Other_ <br /> Building lype: _Single Famiiy _Duptex_Townhouse _Multi-Family �mmercial <br /> Type of pro ect: New Addrtion / Remodel Repair_T.I. Sign_Spnnkler Demohtion_Change of Use <br /> DESCRIPTION OF W ORK(additiona�space pmv�ded on�he back): <br /> �P�- '-I R�F teP Ny.� u rv�rs w ��.i � . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typc o(Pro�ed: _New_Addn �Alteretion_Repair Typc o/Project: _New_Addn _Altcratian_Repair <br /> Show Number(pJ oflaYures Show Number(q)o/�rtums <br /> � AIC-airhandlingunits Toilet <br /> � Porced air s stems Bathtub <br /> Gas piping Lava�ory(wash basin) <br /> � Walerheater Shower <br /> Gas lireplace Ktichen sink 8 disposal <br /> Gas rangc Dishwasher <br /> Clolhes dryer Clolhes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/badmop/etc. <br /> Heal pum 6ackllow reventer <br /> Unil healcr Unnal <br /> Boiler Onukin Foun�ain <br /> Refrigeration Floor drain <br /> Woodstove Grease Irap <br /> Ouclin Roof drains <br /> Olher ftb�crvP Un��e3 MedicalGas <br /> SPRINKLER / SUPPRESSIOM SYSTEM other: <br /> Number of Heads Other: <br /> I hereby ceMy thal l have mad and ewminetl Ciis a0�l�eition and know Uie sime lo he Wn and mrmct/�pmvisions af la»s Tnd oNinances goveming ihis type o�work w.7 bo mmP4eA <br /> w0�wlieMer spcuF.cd herem o�nul.The ganOn9 at a pe�mrt Jces not prewmu tn yke nuthurrty la vwULL or ranwl Ne pmvision olany o�hcr state or bctl IawreguLmnp wnsbuUian <br /> Thal l am aullion[M by Ne v+ner o/ihis pmperry lo perlo��e waAc Iw�Mirh apPlicalion rs mado and I eompN�+N Ue 54�1e ConRadors Law IB 27 RCW antl 29610�A WAC. <br /> ���i`,�� �����3 ��Z <br /> O or/Au�hod ent ignaturc Dalo (RevisedG2012J <br />