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r � � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALlPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , Everett, WA 98201 •425-257-8810-FAX 425-257-8857 -vr�vw everetriva org r , <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �ID—� _/ <br /> SITE ADDRESS: ��OS 'I31I1 S�. EV@fetl, WA 9BZU� PROP[R7v iax a P R�tl u O , <br /> L <br /> LEGAL tor new consimcaon Snon PiavsuDC�v�son lot No_ lailarn coOY 0�long�rya!desc������o�) <br /> OWNER EVERETT PORT OF ��o.��ie�ma�i <br /> :.c�,�ss PO BOX 538 a�r�si�«�z�o EVERETT, WA 98206 <br /> cor+rancroa Reliance Fire Prolection �� i ��c a REUAFP 102L1 <br /> Aaa«ss PO Box 428, Preston. WA 98050 P�o��,em�� 206-682-6636 <br /> TENPNT BUSINESS NAME CONTACT FOR PERMIT <br /> Eagle Mortgate �,h��„�E.�,�, mike@reliancefire.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 500 <br /> E�•sbng Use af Bwid�ng HEAT SOURCE <br /> Proposee Use ol Budtlmg Gas_. Etcu��c_ Omer_ <br /> Bwltl�ng type _Single Family _Duplez_Townnous^ _P.tulu�Fam�ry _Carmer��al <br /> Type of pro�ect _New _Addrt�on _Remodel _Repa�r_T i _S�gn_SormKler_Demcidmn_Cnar.;e o!Use <br /> Descnplion of Work faCComnar space prov�eed en tne 6ac�) <br /> s� �...a wP� <br /> Have you s[arted working wrthout a pennit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project _New_Addn _Nterabon_Repav Type ol ProJect'. _New_AAdn _Alteratwn_F�epau <br /> S�ow Numbcr(WJ oI/irfures Show Numbrr(n)o/l�rtwes <br /> !VC—au hanOhng unds Tcdel <br /> Forcetl a�r syslems Bathtub <br /> Gas pipmq Lavatory pvash�as�N <br /> Waten c�ater I Sho�.ver <br /> Ga5 hreplaCe � KdChen sink 8 tli5pO5al <br /> Gd5 ranGB UiShWdsher <br /> ClothCs tl Cr CIOIhes vr�5her <br /> Range hood Water heater <br /> Exll:lu511dn � $�nk (SCrviCC�bTr/n�a !B�C � <br /> Heat pump HaCkllow reventer <br /> Und healer U��nal <br /> f3o�ier Dnnkmq Founlam <br /> Re�ngeralion Floor tlra�n <br /> Woodstove Grease tra <br /> Uuclm Rool dra�ns <br /> Other MeO�[al Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other <br /> Number of Heads 2 Olher <br /> I hereby cen�ty Ihal I have�Catl anU CRamineC IhiS appLCJlion an�know I�e 5ame Io he�rue anA conecl All provisions o��aw5 anC ortlin,Mces gove�ninq <br /> iha lype of work wil bc compi,ed��+I�wre�her speaGeO heran or nol The granlmg o1 a permA dDes nol presume lo gwe aut�o�dy to v�olale or CanCel <br /> ihe O�onsm�ol any clher staie or iocai iaw regoWl�ng conslrucUon or Ihe petlorma�ce ol wnstmcUon iha�i am aul�oi¢etl Oy Ihe Ownf�ol lhrs Orppe�y <br /> Io petlorm ihe Hoik 1or wh:[�appl¢aLon is ma�e antl I[omply vnl0lhe Slale COnlyd�lors Law 18 2�RCW B�d 296 2004YAC <br /> w�il�e o9ioaizo�a <br /> OwnerlAulhonxe�Agent Signalure Ddte (Rev�Setl 2R011) <br />