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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/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 /> PROPERT!TAX H PERMIT fF <br /> SITE ADDRESS: p — ' � <br /> '7 ! �-r,, <br /> LEGAL lor new cons�ruction: Short P atlsubdivision <br /> Lol No._ (attach copy ol long legal desctiptian) <br /> OWNER JC,eea�.w � � w� PhonelE-mail <br /> �ddress �z�� ��, • � J C <br /> CitylState/Zip 'r C /( Lt/ ��� <br /> APPLICANT:�Owner OwnersA9en1 _CoNmclor _Conlractor'sAgen� _Tenanl(m�siv��:oaaieneroim�eemnommeo«nerioao.oMmv,e+pace� <br /> CONTRACTOR w <br /> State Lic.# Cit Bus. Lia# <br /> PhonelEmail <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> HEATSOURCE' <br /> Existing Use of Building ���,,. � � <br /> Gas Electric_ Olher <br /> Proposed Use af Building <br /> Bullding type: ;�Single Family _,Duplex Townhouse _Multi-Family _Commercial <br /> Type of pro�ect: ._New _Addition _P.emodel Repair_T.I._Sign_Sprinkler_Demolition hange of Use <br /> DESCij1P,TIONOFWORK(adddionalspacep�ovid�donil�ack':/ � �`C � J � �.f�,�.V <br /> � n�_ c r_r ." � <br /> �{/1cl , � e'� �,�,qt ��--��r �. �� C / J � <br /> - ��j_ , 1 r� <br /> , � � � ��� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of FroJact: _Naw_Addn ,_,Alteration_Ropalr Tyno of ProJecl: _New_Addn _Alloratlon,_,Ropair <br /> Show Number(N)ol fixfures Show Num6er(N1 0/Iixtures <br /> A/C—air handling uni�s I Toilet <br /> � Forced air systems Bathtub <br /> Gas piping I Lavatory(wash basin) <br /> ' � Siiower <br /> � Water heater . <br /> Gas fireplace �� Kitchen sink&disposa� <br /> � Gasrange I Dishwasher <br /> Clothes dryer i Clothes washer <br /> i Range hood ' Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc) <br /> � Heat pump I Back(low prevenler <br /> ' Unit heater Urinal <br /> � Boi:er Drirking Fountain <br /> Refrigeralion � Floor drain <br /> � Woodstove � Grease trap <br /> Ducting i Roof drains <br /> � Olher ! Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ! Other: / <br /> I NamberofHeads � Olher: <br /> I hciebi cemty that I ham reaC antl c.ammed ih��.s appi�cahon nnC know the some lo Oa Wa antl wrrcct.All pmv�sions ollewe and oNinences goveminq Ihis type ol work xill be conpte� <br /> v.�;h�sltetllef SpecRed ifetoin or nol.T�e gr9nIM9 0l a perlNl tloes�rl t pmsume:o giva aul�orrty to violaie or wnccl t0e Drovision of any ether stata or bwl law regalolin�construction <br /> 1 rat I am aut�onxetl Ey t�a owner oll�i�pro y Io p rm Ihe rk fot which applicelion Is maCe anC I comply c:�h me Siaae Coniractcrs Law 1B 27 ftC W a��2P5 2dJA WAC. <br /> '� � =---,_ .�- .Z v�- 7 �3 <br /> � � D"ate (Rovised3/2073) <br /> OwnorlAulhorized Agonl5lgnaluro <br />