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PERMIT APPLICATION <br /> BUILDINGII'�IECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SFRVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810— FAX 425-257-8A57—w,.w•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROPERTY TA%k PERMIT N , _/r�` <br /> SITE ADDREGS�S: � ) ����� r �N <br /> 1 ,./l ���� t L�/(- <br /> LEGAL for new conslmclion: ShoA PlaUsubdiwsion__ _.__ _ .______Lol No . .__ (attach copy of long legal descnplion) <br /> � Pnone/e-mai� �jz5 7s`"'�7 'I3/ � <br /> OWNER . ' ' � ) 1 � c <br /> Address <br /> ��,3�- � �I`C�Gti � �nylsletcrz�p f /`�� "1 J <br /> CONTRACTOR L&I Uc k .✓I�.- � l C <br /> r\ � � .�.1 /7 �/Z� 7 S 3`� <br /> Address��' �lU ' � . //� /i �i T' PhonclEmail <br /> TENANT BUSINESS NAME CON-yT'A�CT FOR PERtdIT{. �,.� <br /> � ' : �-�-Lc? ' ,t>e G"! <br /> �!:mer�-��,�� � �'L !l �_ ��/ �!d'�6 .�'. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WOR�_/__� `/%�'-' _ __ _____ <br /> Exisling Use of Building___—________-------------- <br /> HEAT SOURCE: <br /> ProposedUseofBuilding_______--- Gas. .__ Ebcuic____ Other .__ <br /> Building type: __Singie Family _Duplex_Townhouse __Multi•Famity�Commercial <br /> Type of projecl: __New __Addition __Remodel _Repair_T.L iSigrf--SPrinkler___Demol�tion___Change of Uso <br /> Destriplion of Work(addition,,l spaco providad on fhe back): <br /> //�'C'�`(�(�' d;,ti� �/t t�i ('C_�'i �'�, .-. <br /> v <br /> Have you started working without a permit? ____YES _/IVO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typu of ProjocL• ___New___Addn __ Alteratlon. . Repair 7ype of Pro' et: . New Addn _ Alleraqon Repalr <br /> Show Num6cr(M)ol l7xrores Show Numbcr(q ol firturos <br /> A/C-airhandlin units I Toilet <br /> Forced air systems � Bathtub <br /> Gas piping I Lava�o (wash basin) <br /> Water heater ShOwBt <br /> Gas lireplace Kilchen sink 8 dis sal <br /> Gas range Dishwasher <br /> Clothes d er Clothes washer <br /> � Range hood I Water healer <br /> Exhaust fan Sink(scrvicc�bar/mo Intc. <br /> Heal pump Backflow prevemer <br /> � Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration ' Floor dram <br /> � Woodstove I Grease ira <br /> Rool drains <br /> � i Ducling Ivieditai Gas <br /> � Olher------------ I <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> I Number of Heads I Other. <br /> I hereby cartity lhat I have read and oxamined this application and knov he same lo bo tme�nd corroet.NI prwisions ol lam nnd ordinanwf gwom�n9 <br /> lhis type of v.vrk will b�wmplied vnlh vRmthcr speciGed hercin or noL l�m graNing o1 a penr�d does nol prnsuma lo givo aWhority to violato w wncel <br /> Ihe provision of any olher slale or lowl law regulaling conslruction or Ihu podormance ol consWciron.Thal I am au�horizoil by lhe wmer ol Ihis{noperty <br /> . 1� r�{thc work lor which application is mado and 1 comply with tlw Stale Condacton Law iB27 RCW and 296100 WAC <br /> � G �'�-� - ���� (Rovisod2l20f7) <br /> f� nor Authorka" Agont Signaturu Dalo <br /> i'Z <br />