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( <br /> PERMIT APPLICATION <br /> BUIL.DINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar 5t., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM ! — "�/ <br /> SITE ADDRESS: vRoventY TAX N PERMIT� <br /> O O/'/OOlD3 IIII ' brj�l <br /> LEl3Al for new constrWion: Srort PlaVaubd�visbn Lct No.____ (tlbG�mpy of lorp lepal deacriplion) <br /> OWNER PhonelHneil �' . �G� <br /> nve,n� k c�a,s�irn,e z.�4 w-/� ,03 <br /> CONTRACTOR G' C.r,c � l�.c�. �a i u�.� . • - o <br /> ,qda�g PNonUEmeil <br /> U3 NESS E CO C 2��� <br /> PhO�NE•m�il 7 �C�l0 • ;1 $!'�� '•'��j <br /> •/ 'f�fr1 <br /> BUILDINfi PERMIT APPLICATION CONTRACT PR10E OF WORK{ci�5 Z Z <br /> Exialing Uss of Bullding HEAT SOURCE: <br /> Proposed Uee o(f Bu—ildinp Gas �Eleetric Olher <br /> Buimingtype: f—�ingbFamiy �Dup�ez_Townhouse _Muld•Femi�y ,_,.,,Commercial <br /> Type ol praject: . Jlew _Addition _RemoNl �Repair_T.I._Sign_Sprinkler_DQm01i�lOn_Chang! Of Use <br /> �ssuipti�notWorkpdd�tion 1pA�Provrd onfh ec�: w.� fi� �N � ^� .�u.rhnc.tt <br /> �,x.plac.e_ Qw� 9D�Jo �w Nae.� <br /> r�-o ��` <br /> Have you steRed workinp withart a pertntt7 Y83 �,NO <br /> MECNANICAL PERMIT APPLICATION PLUMpING PtRMIT APPLICATION <br /> rypodProJan: ylaw_�aan _�k.ntian eWir TypedP�ect: _Naw_Addn _�nuxlon_ti•w�r <br /> ShorNumbv(�ryol/4turef S�owNumWr(1 o/fufures <br /> A1C—airhandlin units Toilol <br /> Fotced air s slems Bathlub <br /> Gaa i i Lava�O w88h b251n <br /> Waler heeler S�ower <br /> cu fire lace IatchQn cink 6 tlis osa� <br /> Ges ran e Dishwaaher <br /> Clothesd er Clotheswasher <br /> Ran s hood Wator heater <br /> Exhausttan Sink service/be�lmo atc. <br /> Heat um BaGkflow rlWntEt <br /> Unit Mater Ut�nal <br /> Boller Drinkin Foun(ain <br /> Rel� eration Floortlfain <br /> Woodstove Gmaee tra <br /> Duclin Roof dfains <br /> Olher Medical Ges <br /> SPRINKLER/ SUPPREa310N SYSTEM other <br /> Number of Heads Other. <br /> I hereby ceniry that I nave read and examined th0 applintion and know the spme lo be true antl caretl.NI provisione a'laws and ordinancaa ppveminp <br /> Ihl�lype of work�.i�l De complied wi�h whNher spetified herdn or not 7Te prantinp of�py�nit doea not presum�te pYe wlhoriry(o violete or C�no.l <br /> Iha provision ol any other stelc or lonl law reguleting�onsWaion a Ihe perfortnarnz at aonsiruCtipn.That�am authoYiad by the o'.K'.er of thia propeRy <br /> to perform Ihe v�orK lor which appicalion is maEO and I aomqy x.lh the Stale ContraUore Law 18.27 RC W end 298.200 WAC <br /> �..t.�.��.a�...� <br /> OwrorlAWhorized AgenlSigneturo Date (Ravls�tlT/lmt) <br /> � �d tiooE ��N waoa �ti �< <oz �ai���N <br />