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� � c � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERE7T 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�PM •-�`"I Z <br /> SITEADDRESS: PROPERTYTAXN ER ITN <br /> Z U�G C ' <br /> LEGAL for new conat�uclbn: Short PleVeubdivieion Lot No._. (attach copy ol bnp kWl deaaiptlon) <br /> OYVNER PhonU6mail <br /> ddress CirylStatelZlp <br /> CONTRACTOR � � 'o.�L 8 I Lic.# '�e US� <br /> ddrea G t+ Aa..'� � � PhrnNEmail �0 6� �7Q5 �^10C'� �i�i Qcs•CU�+ <br /> TENANT BUSINESS NAME ONTACT FOR P R IT� �e O <br /> t. <br /> � p PhonUE-mail 2c� 6 S� wto+�-�e .�;ce0�.�1 co� <br /> BUILDIN PERMIT APPLICATION CONTRAC7 PRICE oF WORK`��c'�` <br /> Ezisting Use of Building MEAT SOURCE: <br /> Proposed Use of Bullding Gas Eleetric othar <br /> Building type: _Singte Femily _Duplex_Townhouse _Mutti•Family ✓Commercial <br /> Typa of proJed: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> pes'�ptienflfW�(�ddit�,rk:efCa SvggfeS$boJ�. S� $�'Q w� <br /> "� 3 <br /> 9�r <br /> Have you shrted working without a permit7 _YES �NO <br /> MECHANICAL PERMIT APFI.ICATION PLUMBING PERMIT APPLICATION <br /> Typa of ProJeet: _New_AOEn _Alteretlon_Repalr Type ol ProJxt: _New_Addn _Akaratlon_Repalr <br /> Show Numbar(MJ ol ilxfures Show Numbsr(M o/flxfwa <br /> AIC—airhandlin units Toilet <br /> Forced eir s stems Bethtub <br /> Gas i In Levata wash besin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washar <br /> Ren e hood Watar heeter <br /> Exhaust fan Sink servicelbar/mo lelc. <br /> Heat um Backflow reventer <br /> Unit healer Urinal <br /> Boiler Drinkin Fountein <br /> Refri eralion Floordrein . <br /> Woodstove Greasa tra <br /> Ductin Roof dreins <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SY8TEM Other: <br /> Number of Heads Othar: <br /> I hereby certity that I hava reatl and examinetl ihis applicalion anG know the same to be true and wrrect.All provialons ol laws and ordinancea poveminp <br /> t�is type of work vnll be camplied vri�h whether specified herein or not.71ie granting of a permH doea not presume to give aut�oAty lo vidate or cancel <br /> t�e provision ol any ather slete or local law regulaling construMlon a tha{reAormance ol consductlon.That I am authorized by tM ownar of ihia pioperry <br /> to pertor/m1lhe work lor which epplicalion Is made antl I compty with l�e State Coniredon Law 18.27 RCW and 298.200 WAC <br /> L����JA � al�/�7J�- <br /> OwnedAuthoAzadA ntSignature a�e (ReWsetl?/20f1J <br /> 'lZ <br />