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( ! <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLiT10N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> ApPLICAT�ONS ARE ACCEPTED FROM 8 AM TO 4 PM � .� "'�Z <br /> SITE ADDRESS: PROP�RN TA%N RMIT fl <br /> zw, ��r� v •".. �r,.�. "�y <br /> LEGAL for new consin�dlon: Short P�aUsubdlvislon _Lot No._ (ettach copy ol long lepal desuipllon) <br /> OWNER L�w�� lt1 n..11cs PhoneJE-mail 4y3 3r� 3q6! L�^'�Ph��yBG�tA�b� <br /> ddrese �ft)9 . 'r+✓�i1-V��c,� �r�v� City/StatelZiP (t vVa.'�" �wA" � F�3 <br /> CONTRACTOR O�..r er �g�L16•� <br /> tldress PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE•mail <br /> BUILDING PERMIT APPLICATION cONTttncT PRICE oF WORK <br /> ExistingUseofBuilding N�M- � R��`^"` HEATSOURCE: <br /> ProposedUseoiBuilding ���"� r Ry•�JQ^'�`- Gas EIMrk Other <br /> Building typa' �Single Family _Duplex_Townhouse _Mulll•Family _Commercial . <br /> Typa of proJect: _New _Addition _Remodel �Repair_T.�._Sign_Sprinkler_Demolilion_Change of Use <br /> Dascription of Wark(additional space provlded on the bacW/: � <br /> �Na�'v" }'�t�'1"'� Qa(Il.is/�+�C�` L.(sas� <br /> Hava you started working without a permlt7 _YES x NO . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJecl: _New_Addn _Altorotlon_Repelr Typa ol ProJact: _New_Addn _AlbnUon�[„Rep�ir <br /> Show Num6er(p)o//Ixtuns Show Num6er(y ol ilirtures <br /> AIC-airhandlin units Toilel <br /> Forcedairs stems Balhtub <br /> Gas i in Lavato wash basln <br /> Waler heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Ciothes d er Clolhes washer <br /> Ran e hood Water heater <br /> Ezhaustfan Sink service/badmo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Udnal <br /> Boiier Drinkin Fountaln <br /> Refri eralion Floor dra(n <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM otner: <br /> Number of Heads Olher: <br /> I hereby cerliry that I have read and examined�his appllcalion and know the same lo Ee true and cartect.All pmvisions of laws entl ordina�es goveming <br /> this rype of work will be complied wilh whelher specified herein or nol.The granting ol a permit dcee not presume�o give auttwAty lo Wolate w wncel <br /> the provislon of any other stete or local law regulaling construcllon or U�e perlormance olconsirucllon.That 1 am authorized by Iha owner ol lhle property <br /> lo pedorm lho wotk fa which applicetlon Is made and 1 compy wi�h ihe Stata Contredon Lew 18.27 RCW and 298.200 WAC I <br /> �_-�— `� /z/ ze�z <br /> OwnedAuthodzad Agent SlgneWre Date (Redsed?/2011J <br />