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� � - <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF FVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98207 -425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T04 PM � � 0� "�� <br /> SITEADDRESS: ,.� � n� PROPERiYTAXII PERMITM <br /> �2 I l�� C i I� S�� r I _ o <br /> LEGAL for new construdion: Short PleVsubdivision Lot No._ (attech copy of long lepal dexription) <br /> OWNER l ' � ' �C 1 V C�YV1�C `tti Pnone/E•meil �I U �c -- ���� - 3S5`�- <br /> ddress L Z (�C C�-i��Sv h �L C�r�stet�z�o C�fe.r�. � U 3 <br /> CONTRACTOR ��V e F Gl l'�l�C LL�- L&I Lic.# <br /> dress !I ` �� � �U � � `�Vv � \ $U 1 'v PhonelEmeil yas- �� i- �i3� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUIIDING PERMIT APPLICATION CONTRACT PRICE OF WOR{P� <br /> Existing Use of Building 5� � HEAT SOURCE: <br /> Proposed Use of Building Gas Etearic other <br /> Building type: _Single Fami�y _Duplex_Townhouse _,Multi-Family _Commercial <br /> �fype of project: _New ,_Addition _Remodel _Repair_T.I._Si�n_Sprinkler_Demolition_Change ot Use <br /> nescription Of Wafk(eddilional space p�ovided on tha backJ: <br /> �-,p.��.c�c.c�-J �-�nac� (�G�s� <br /> Have you sWrted working without a permit9 _YES _NO <br /> MECHAIiICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypaofProJect: _Naw_Addn _Alteration_Repair TypaofProJe�t: _New_Addn _Altantion_RapNr <br /> Show Number(M)ol fixtures Show Number(MJ o/fiirtures <br /> i AIC—airhandlin unils I Toilet <br /> � Forced air s stems I Bathtub <br /> � Gas i in ! Lavato (wash basin <br /> � Water heater �� Shower <br /> Gas fire lace I Kitchen sink&dis sal <br /> I Gas ran e I Dishwasher <br /> I Clothes d er I Clothes washer <br /> � Ran e hood Water heater <br /> I Exhausl fan Sink servicelbarlmo letc <br /> ; Heat um I Backflow reventer <br /> Unit heater ! Urinal <br /> Boiler � Dnnkin Founlain <br /> � Refri eralion Floordrein <br /> '� Woodstove I Grease tre <br /> � Ductin I Rooidrains <br /> � Other � Medical Gas <br /> $PRINKLER/ SUPPRESSION SYSTEM � Other. <br /> '� Number of Heads i Olher: <br /> I hereby certity thal I have read and ezamined this application antl know the seme to be inie end cottect.Ail provisions ol laMs end ordinences goveminp <br /> Ihis type ol work v.ill be complied with whether specifietl herein or no�.The prenling of a permit does not presume to give aulhority to violate a cancel <br /> the provision ol any olher stale or Iocel law regulalirn conSWction or lhe peAormance of construclion.Thel I em eulhc -�tl by the owner M Uis propeny <br /> to paAortn the Hork forxl�ich applicalion is mede an�I wmply vnth the Stete Contraqors Law 78.27 RCVJ and 296.20. ..AC <br /> 11�, � � ��� ��� <br /> OwM1eM �biized Agent Signature �Date (Revised7/t077) <br />