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; <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98207 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �-0�3"I?' <br /> SITE ADDRESS: PROPERTY TA%M RMIT/ <br /> .�'//` �i�.� y•J 2- 7°�Z�y7 3- 00 <br /> LEGAL 1or new wnstruction: Short Platlsubdivision Lol No.__ (attach wpy ol long legal descrlpllon) <br /> OWNER �� ��� K PhonelE-mall ylsl Z31� b2b� <br /> Adtlress �S 1� �a[ �C <br /> Ciry/Slate/ZiP �IIC� � k �gZ�� <br /> CONTRACTOR �rn .ru """� �s i uc.x ,���r,E'/t S 933 0Z <br /> Address I�S�S Vii i«�c . �v'C PhonGEmall (Y�fJ36�• /68� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ��Kc K�^ 1 r ew. <br /> PhonelEmail �ii4�' ��; � �^^"' . <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use ot Building HEAT SOURCE: <br /> Proposed Use ai Building Gas� Electric� Other <br /> Buildingtype: J[,SingleFamily _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of proJect: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of;se <br /> DeScription of Work(addifional spaca provided on fhe back): � f � �4 �« pf F, ,ce- �1�r— 7 KG- <br /> on <br /> 7,y6�1 3 �.�+ faoi.y.� ! foll ro.�wl <br /> Have you started working without a permit7 X YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProJect: _New_Addn _Alteretion_Repelr TypeolProJe�t: _Naw_Addn _Alteratlon_Repalr <br /> Show Number(N)o/flxtures Show Number(MJ o/flxtures <br /> AIC—air handling units Toilet <br /> Forced air s stems Balhlub <br /> Gas pi in Lavalo wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ren e hood Water healer . <br /> Exhaust fan Sink servicelbarlmo letc. <br /> Heat um Backflow reventer <br /> Unit heater Udnai <br /> Boiler Drinkin Founlain <br /> Refri eralion Floordrain <br /> � Woodslove Grease tra <br /> � Ductin Roof drains <br /> � Olher Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM other: <br /> Number of Neads I Olher: <br /> I�ereby certily ihat 1 hava read and examinetl Ihis applicallon and know Ihe same to be tfue and correcl.All p�vvisions ot laws anC oNinances qoveminp <br /> this type ol work will be complied vrith whether specified�erein or nol The granling ol a permit tices nol presum�e to give authonty la Wolate ar wncel <br /> the provision of any olher stale or local law regulating consiruction or t�a peAormanca of conslruction.Thal t am auttrorized by l�e owner ol tNs p�operty <br /> to pedorm Ihe v.ork for�Mic�applkalion Is made and I compy with lhe Stete Contractoro Law 1P.27 RCY+and 298.200 WAC <br /> �/� �Z�Z <br /> OwnerlAuthorized Agent Signetura Dalo (ReWsM 7/POf 7i <br />