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i i, <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evered,WA 98201 -425-257-8810—FAX 425-257-8657—www.everetlwa.org <br /> AppL NS ARE ACCEPTED FROM 8 AM TO 4 PM � `������ <br /> SITE ADDRESS: PNOPERiY TAX M PERMI;a <br /> U <br /> LEGAL for n>w conslNcllon: Short PleVsu _Lol No._ (altach wpy ol long legal descripllon) <br /> OWNER [, F f�l L PhonelE•mall Z � <br /> ddress V�..I�� I City/Sla�nJilp ���/�..� � <br /> coNrr�ncroR T�lFIZA cnc�2GCs' �a i u�.n N F IZA C i— 2�, /7 �j <br /> ddress S Q/�(C' (fQ. �� PhonelEmail �� ^�1C0^ T JD A <br /> � TENANT BUSINESS NAME CONTACT FO�j PE�RtMI� K,����LF� <br /> (�O G <br /> P�one/E-mail ZS 'S� � 3�D <br /> BUILDING PERMIT APPLICATION coNTw4CTPRICEOFwORK �u/ U <br /> Existing Use ot Buikiing HEAT SOURCE: <br /> Proposed Use of Building Gae_ Eiectric O�her <br /> Buildingtype: _SingleFamily _Dupiez Tawnhouse _Multl•Family _Commercial , <br /> TypeofproJecl: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change otUsa <br /> Descriptlon of Work(additional spece prov(ded on�he back): <br /> f��Lc� c�r.�^� aF G�A S /�c-rc�lz <br /> Have you started working without a permit7 YES ,G,NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIi APPLICATION <br /> TypeotProject: _New_Adtln _Altaretlon_Repalr TypeolProJoct: _Naw_Addn _AlteraGon_Rapalr <br /> Shaw Number(N)ol Rxtu/es Show Number(N)ol flalures <br /> AIC—air handling units Tailet <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash basin <br /> � Water heater Shower <br /> Gas fire lace Kitchen sink 6 dis osal <br /> Gas ran e Dishwasher <br /> Ciolhes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhauslfan Sink servicelbar/mo /elc. <br /> Heat um BackBow reventer <br /> Unit heater Urinel <br /> Boiler Drinkln Founlain <br /> Refri eratlon Floordrain <br /> Woodslove Greasa tra <br /> Ductin Roof drains <br /> Other Medfcal Gas <br /> SPRINKLER/SUPPRESSION SYSTEM other: <br /> Number af Heads Olhar: <br /> 1 hereby ceAity Ihal I have read and examined ihle application and know tAe same to be INe and correct.All provislons of lews and ordinances goveminq <br /> thls lype of work will be complied with whether specified herein or not.The gran�ing of a permit dces not presume to give authoAty�o vlolala or cancel <br /> tho provision of any other slate or local law r ating const�udlon or Ihe peAormance of consVuctlon.That I sm authorized by Ihs owner of this properry <br /> !o pertorm t tk for which applic on �da and I comp 'th ihe Slate Conl2ctors Law 18.27 RCW and 298.200 WAC <br /> �, L� � � <br /> OwnerlAuth zedAgmtSlgnature , Date (Reviscd?/POf1J <br /> s <br />