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( <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPL.UMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EYERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-6810—FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � I ':��� <br /> SITEADDRES3: s, PROPERTYTAXN PERMIT OZ_ <br /> � O t�G��' Y1e 1 <br /> LEGAI for new conslrudion: S�oA PlaVsubdl islon Lot No._ (etlach copy ol long lapal desaiptlon) <br /> OYVNER r .D � �7 PhonelE-mell �� — n 2 <br /> ddreas //i o V C�' /-,tG h� �f/ S d City/Stete2lp <br /> CONTRACTOR a, � ��'�L10'M � p y <br /> dtlress C � � a � 98 P�onelEmail � 'Z � / 2U <br /> TENANT BUSINE S NAME �a ~ ONTACT�FOR PERMIT <br /> � �t�'' j��-�/aY <br /> � p � �2� PhondE-mail � �� <br /> BUILDIN PERMIT APPLICATION coNTw4c7 PRiCE oF woRK d ' <br /> ExislingUseotBuilding �.Qr7u�s f w k ?�' HEATSOURCE: <br /> Proposed Use of Building�o� t ¢ D e�� Gas +�Electrie O�her <br /> Building typa: _Single Femily _Dupiex_Townhousa_T Multi•Family,�Commercial <br /> Type ot project: _New ,_Additlop'�Remode Rep _T.I._Sign_Sprinklar oliti ge o �. <br /> Description of Work(adaitknel spece p��uvtde��Lheh <br /> Have you atertad working without a permit7 _YES _NO <br /> MECFIANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJael: _New_Addn _Alteratlon_Repalr TypeolProjael: _Naw_Addn _Albntlon_R�pelr - <br /> Show Numbar(M)o!flxfures Show Num6er(M o/flrfuros <br /> PJC-air handiin unils Toilet <br /> Forced air s stams Bathtub <br /> Gas i in Levato wash basin <br /> Water heater Shower <br /> Ges fre lace �Kitchen sink&dis osal <br /> Gas ran a Dishwesher <br /> Clolhes d er Clothes washer <br /> Ran e hood Waler heater . <br /> Exhaust fan ,Y Sink servicelberlrtw /etc. <br /> Heal um Backflow raveMer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlein <br /> Refri eration Floor drain <br /> Woodstove Grease tre <br /> Dudin Roof drafns <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM - Other: �w ,�..t� ( <br /> Number of Heads Other: C �N <br /> I hereby certify that I have read and examined lhis eppllcation end know the same lo ba tnie and correct.All pmvisiona ol laws and ordinancee qovemirq <br /> this type ol work vrill Ge ccmplietl withw�elher specifetl herein or not.The grenting of a permit dcee irot Drecume to pive euNonty lo violeta or rancd <br /> the provislon ol any ol slete or local law repulaUng conslruction or Ihe pedortnance of constnxilon.Thet I am authodzatl by tM amer ol ihis propery <br /> to peAorm the wo r which epplication I made a mpy wiN tM Sute Conimclon Law 18.27 RCW and 298.200 WAC <br /> U <br /> wnerlAutho �ed Age) Signature Date (ReWaed7/1071) <br /> \!/ � <br />