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� <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMSINI�/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERE i1' PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-25%-8810—FAX 425-257-8857—www.everettwa.orgn <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �a."1 `�I <br /> SITEADDRESS: PROPERiv7AXp T�X �O ` U <br /> _� <br /> LEGAL lor new const tion: Short PIaU divislon Lot No._ (ettach capy ot long legal descriplion) <br /> OWNER Phone/E•mail <br /> Address CltylSlale2lp <br /> CONTRACTOR 3 L 81 Lic.k < G <br /> Address �`i PhonelEmail <br /> TENAN �USIN S NAME CONT CT FOR PERMII' �R D <br /> Phone/E•mail — �— � <br /> BUILDING PERMIT APPLICATION coN7RAcr rRICe oF WOR O <br /> Existing Use of Buiiding HEAT SOURCE: <br /> Proposed Use of Building �""�'�'��TQ��� Gas Elecldc_ Other <br /> Building lype: _Single Family _Duplex_Townho�u�se Multi-Family �Commercial <br /> Type of project: _New _Addition _Remodel V Repair_T.I._Sign_Sprinkler_Demoiition_Change of Use <br /> Descrip�ion of Wark(eddifional soace p�ovided on the back): �� <br /> /W � <br /> Have you started working without a permit? _YES ,�NO �Nz'!L!t(� ��/ � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypaofProJect: _Naw_Addn _Alteratlon_Repair ,! Typ:3ofPrejecC _New_Addn _Allendon_Rapair <br /> Shnw Numbar(a)0/�ztures Show Numbar(N)of/ixfures <br /> A/C—airhandlingunits Toilel % <br /> Forced air s stems / Bathtub <br /> Gas pipin Lavalo (wash b in) <br /> Water heate .v Shower <br /> Gas firepla'ce J Kitchen sipK&disposal <br /> Gas raA e Dishw Sher <br /> Clothes d er v Clotfies washer <br /> ;Ran Ehood !Waterheater <br /> � Exhaust fan - Sink(servicelbar/mopletc.) <br /> i Heat pump Backflow preventer <br /> Unit heater / Urinal <br /> / Boiler Drinking Fountain <br /> / Retrigeration Floor drain <br /> Woodstove Grease trep <br /> / Ducting Rootdrains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. � <br /> Number of Heads Other: <br /> I hereby certiry that I have read and examined this application and know the same to be true and cortect.All provisions af laws and ordinances goveming <br /> this lype of work will 6e complied wilh whelher ecified herein or not.Thu granting of a permit does nol presume to give aulhority to vloiate or cancel <br /> the provision f any olher slale or local law re Ialing conslruclion or Ihe peAormance of conslruction.That I am authorized by ihe owner ol lhis property <br /> to perfo work for which application is ade and I cumply vrith Ihe State Contrectors Law 18.27 RCW and 296.200 WAC n / <br /> �_/6 —�/� \�"V <br /> erlAuthorize AgentSignature Date (RevisadY20f1) <br />