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c � � '.- <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBINGISIGN/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 ,7.`�O�"�� <br /> SITE ADDRESS: PROPERTY TAl(N PE IT i _ <br /> ��a t i Fue,.�tt <br /> LEGAL for new construction: ort Plat/subdivislon Lot No._ (ettaeh copy of lonp legal desuiption) <br /> OWNER Phone/E-mel{ <br /> ddress City/Staia/Zlp p <br /> CONTRACTOR GD r � L&I Lic.# G�D `I o �� <br /> Address S 2 0 �ti e s� �/d 0 �PhonelEmeil �z s-S" - 7 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> S 0 •�L �S� PhonalE-meil a d• 9z2 -9�� <br /> BUILDIN6PERMITAPPLICATION CONTRACTPRICEOFWORK 4� ��• � <br /> Ezisting Use of Building s ��� �*+'� '�� - c • HEAT SOURCE: <br /> Proposed Use of Building �[, �� f ��+�5 Gas ' Electdc_ Other_ <br /> Building lype: _Single Famil;� _Duplex_T nhouse _Mulli-Family �Commercial <br /> Typa ot project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_,Demolition_Change of Use <br /> Descriplion of Work(additionel space provided on fhe back): . �� , /O� <br /> j�v <br /> Have you started working without a pertnit? _YCS _NO / � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PE IT APPLICATION <br /> 7ypeoiProJecl: _New_Addn _Akantlon_Repalr TypeofProJact: _New_Addn _AltenGon_RapNr <br /> S�ow Num6er(N)o!Rxturas Show Number(M)o/tlxtunr <br /> A/C—air handlin units Toilel <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash basin <br /> Water healer Shower <br /> Gas fire lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink servicelbar/mo /elc. <br /> Heat um Backflow reventer <br /> Unil heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floar drain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRE8810N 8Y8TEM Other: <br /> Number of Heads Other: <br /> I here6y certiy that I have read and exemined this appllcation and know the same to be true and wrted.Ail provlsions oi laws end ordina�ces Boveminp <br /> this type oi work will be wmplied with whelher specified herein ar not.The prentinp ot a permit doos nol presume to plve authority to violete o��•ncel <br /> the provision of any olher state or local lew regulating wnsin�ctlon or the peAormanca ol canslrudton.That I em authorized by the ovmer ot Ihls property <br /> to peAorm ihe work ich appllcalion is made and 1 comply with the Slate Contredors Law 18.27 RCW and 298.2G0 WAC <br /> . ,, � • // / <br /> n orize�J�l4 ent 3lgnature a e (Ravised 22011) �/� <br />