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�.- � <br /> . � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERE7T PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM `-�� <br /> SITE ADDRESS: PROPERTY TAI(N ERMIT � <br /> /ZOS n� / a /O <br /> LEGAL lor new conslruclion: ShoA PlaVsubdivision Lot No._ (ettach copy af long legal descriplion) <br /> OWNER T PhonelE•meil Zob -3 3-86�� <br /> Address ]. 4 �/ y r . Cilyl51a�e2IP ! V KQ Q � <br /> CONTRACTOR L 8 I Lic.# <br /> Address l 'l-�� PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ;q�pu��$�e.d s�Ml)�. �.o�'Yl <br /> � J (71[��'14 ffr�p <br /> L�('��. Q'f" �"�Q/IILO� PhonelE•mail �O ~ "1-10`7ilA 7��) s�3�7y�� <br /> BUILDING PERMIT APPLICATION coNTRncT PRICe oF WORK g S� o0D -°' <br /> Existing Use of Building VQ� �n� HEAT SOURCE: <br /> Proposed Use of Building �� -S�P Gas Electric_ other_ <br /> Building type: _Single Family _Dupiex_Townhouse _Multi•Famiiy �Commercial <br /> Type of project: _New _Addition _Remodel _Repair�T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Destription of Work(addifional space provided on fhe back): <br /> bgo S.F. oF �'cntpn+ �m�ve.rha..l- -{cr �� S�..pp <br /> Have you started working without a pertnit7 _YES ,�NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: _New_Addn _Altention_Repair Type of ProJect: _New_Addn _Atteration_Repalr <br /> Show Number(M)o//ixtures Show Number(N)oI Rxtures <br /> A/C-air handlin units Toilet <br /> Forced air s stems Balhtub <br /> Gas pipin � Lavato (wash basin) <br /> Waler heater � Shower <br /> Gas fire lace Kitchen sink 8 disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(servicelbar/mop/etc.) <br /> Heat pump BackOow reventer <br /> nit heater Urinal <br /> Bo r Drinkin Founlain <br /> Refri tion Floor drain <br /> Woodsto rease trap <br /> � Ductin of drains <br /> Other Me 'cal Gas <br /> SPRINKLER / SUPPRE331 SY8TEM Other: <br /> Number of Heads Other: <br /> I hereby certify Ihat I have read end examined this applicallon and know�ho same lo be true and corred.All provisions ol laws M ordinances goveming <br /> lhis type of work will be complied vnlh whelher specified herein or nat.The granling ol a permit does not presume lo give authority to violate or cancel <br /> the prov(sion ol any olher stale or lowl law reguiating conslruction or Ihe perlormance ol wnslruction.Thal I em authorized by Ihe ovmer of Ihis property <br /> to peAorm Ihe work lorwhich application is mado and I compty with Ihe State Coniractors Law 78.27 RCW and 296.200 WAC ''� <br /> /—'�- ------�� e/26/„ <br /> Owif�^dAuthodzedAge gnaturo Dale (Revised7l2011) <br />