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r i <br /> \ <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUME3ING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETI' 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 A PM I I�i� `� <br /> SITEADDRESS: �• PROPERTVTAXp PERMIT• <br /> - - ( � 1 �� , Lve. I$lt�'� k 3 - b -�t -02 - <br /> LEGAL for new conslruclion: Short Plal/su6division Lol No._ (attach copy ot long legal desuiptlon) <br /> OWNER � ` � Phone/E•mail — — 'Cv�Q�� Q 1 <br /> Address � C Z CltylSlalelZip W A �l$d�6 <br /> CONTRACTOR , � G. L&I Lic.# <br /> Address PhonelEmali <br /> TENANT BUSINESS NAME CONTACT FOR PERM!T <br /> �v I� PhonelE-mail <br /> BUILDING PERMIT APPLICATION coNTRAc7 PRICE oF WORK <br /> Exisling Use of Building S h l� HEAT SOURCE: <br /> Proposed Use ot Building 5 1— 1� Gas Eieclric Other_ <br /> 8uilding type: �Single Family _Duplex_Townhouse _Mulli-Family _Commercial <br /> Type of projecl: _New _,Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> DescriptionofWOrk(adtlifionelspaceprovidedonlheback): '�j;:�(Z ��F 5�-�A`(��-- �Ct:�� �l��jP��—L— <br /> csg sHEryi�l� rJb , 1�1st���` ye�Y2 Lc„-.�� �o�F <br /> Have you staAed workfng without a permitl �,YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUh161NG PERMIT APPLICATION <br /> Typa of ProJeot: _New_Addn _Alleratlon_Repair Type of Pro�ect: _New_Aadn _Altewtion_Rap�ir <br /> Show Number(MJ o//ixtures Sho�i Number(M)o/Ilxtures <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathlub <br /> Gas ipin Lavato (wash basin) <br /> Water heater Shower <br /> Gas freplace Kilchen sink 8 dis osal <br /> Gas ran e Dishwashar <br /> Clothes d er Clolhes washer <br /> Ran e hood Water heater <br /> Exhausl fan Sink(service/bar/mo /etc.) <br /> Heat pump Backflow preventer <br /> Unil heater Urinal <br /> Boiler Drinkin Founlain <br /> Refrigeretion Floor drain <br /> Woodslove Grease ira <br /> Ducting Root drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRES'310N SYSTEM Other: <br /> Number of Heads Olher: <br /> I hereby certify that I have read and examined thls applicalion and know�he same lo ba Inie and cortect.All provisions of laws end ordinances goveming <br /> Ihis type o1 work will be complied with whether specifed herein or not.The granting of e permit does nol presume to give aulhority lo violata or cancei <br /> the provision of any olher slale or local law reguiating construction or I�o peAormance of conslruclion.That I am aulhonzed by Ihe awner of Ihis propeAy <br /> to pe th`wo�for whic application is made and I comply vnth Ihe Stale Conlraclors Law 18.27 RCW and 296.200 WAC � <br /> � 11-��-�� � <br /> Owne��horized Agont Signature �ate (RevisedY2017) <br />