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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810— FAX 425-257-8857—�wvw.everettwa.org <br /> ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SIT�D�S�� � 11J1�, f� (.L� T �1 PROPERTYTAXN PEgM�XU�� _O`,L,` <br /> LEGALIornewcons�mction: ShonPlaUsuMlrvision_ ._. ______LotNo._ ,.._ (�����hcopyollonglegaldescriptian) <br /> OWNERc ' T,u ' � � � till��-��L- Phone�E-mail <br /> Address � O i T�i f�. ' L. L'C-(LE'� Gty151ate�Zip �����L- �� I.L� !-Y � �Z � <br /> CONTRACTOR 7- �� �� ( L 8 I Lic.# � ✓l- i J �b <br /> ' U �l l L'1,Q� � l �i� �� ���':1- Phone/Email t- Z� ��W� <br /> AJdress ' <br /> TENANT GUSINESS NAME CONTACT OR PE�iM1T <br /> �/-(,,, I 1 , � ry�� � 1 f (�'l�'Ic Sk��'S��Z5�77LS� — <br /> .�L �.1,���`_�, , L�+��- 1._�f (. (,. . L�.y'�� � PnonelE-maJ <br /> BUILDINGPERMITAPPLICATION coNrRACTPRicEOFwoRK_I(c'`/G=_ --. - -------- <br /> Exisling Use o��uilding . . . . . HEAT SOURCE: <br /> Proposed Use ol Bwlding . . _. . . . . . . -. . . . Gas Elec�nc_..__ Other _ <br /> Building typo: . _ Single Family _. _Duplex _ _Townhouse ___MulU�i'. •uily _ Commercial <br /> Type of projecC __.New __. Addilion ___Remodel ___Repair. _T.L __Sign___Sprinkler __.Demolition. _..Change ol Use <br /> Descnption ol Work(nddrtionnl space povided on tAe beckl: <br /> ��ti���zc�� ( ;3 ►�r.�n C�i- S1 J 1t�1,U1,�fC�, lL 1�c.K-���-- <br /> Havc you staned working withoul a permit7 YES ,� NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pro�ecl: Naw Addn Alleratlon Rapair Type ol P�o�ect: New Addn . .Alteraqon Rspair <br /> Show Numbo�(p a!lixfures Show Numbcr(pJ of flxturns <br /> I NC -au h,mdl.ng unds '� Toilel <br /> I Fomed av systems Bathtub <br /> i G�5 n���ii�� '� Lavato Iwash basin) <br /> � i Water healer I Shower <br /> � Gas Irtc lacu I Kitchen slnk 8 dis osal <br /> Gas ranqc I Dishwasher <br /> t Clothes d cr I Clothes washer <br /> � Ran c hoorf � I Watcn c�ater <br /> i EKhaust lan r I Sink(service�bar�moplelc.) <br /> I Hcat purnp i 0ackllow revento� <br /> Und hc;Ycr Unnal <br /> ' Balc� Dnnkin Fountain <br /> � Rein erat�on I Floor drain <br /> � Woodslove I Gieasetra <br /> ' pur.t�n I Roo:drams <br /> Othcr �' Medical Gas <br /> SPRINKLER I SUPPRESSION SYBTEM ! i otner. <br /> Numbrr ol Hc;ids I Olher. <br /> I I�mieby cert:ly Ihat I hava re:W anJ e.an,�neA Ilus appi:wuon and tnaN tlm samo to be ttua 0nd Carect.All prowsion!Ol laws and ord�iunces 9ovMrvng <br /> th�s type d Nak N+II bo complied M+th wfiether speul�ed t�are�n or not.The graMng ol a pertnA does not Gresume to pive aultwrRy to valata a tancel <br /> n�c prov�sron ol any othcr state or bcal law regulaling wnstruct�on or ihe peAormu�ce M co�6trucUon.Thai I am eulMr2ed by ihe wmer o�iMs property <br /> n�ped Ihc v.urk Irn xfi�di appl�u�Uon re mado and I eanp�Y v^�h tho SWto Contraetws Law 78.27 RCW and 298.200 WAC <br /> � �/ ' y/�� u <br /> � f �� �Revised2/Y01/) <br /> o criA �ori; gantSipnaWn ate }/ <br /> L <br />