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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES � � 7`13 <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITEADDRESS: PROPERTY7A%N PERMITp _ �C� - <br /> �2 �iC3�.l:t'� �. �V C��� w �F'z . � � �� . <br /> LEGAL lor new wnslruclion: Short PlaUsubdivision Lot No._ (atlach copy ol long lec�al descnption) <br /> OWNER � 1'� J 11�e��9 p PhonelE-mail <br /> �7-- �Yzr coi�,9 GIJ� I i��(Z ( <br /> nddress��� � Z.. l�'� '�2 1 Q�a"�4 W� City/Stale/Dp � �� <br /> APPLICANT.�u'ner Owner'sAgent Contractor CoN�actor'SAgCnI _Ten�nt�Tusio�omteaie^ero�mn�er.thommea4neraeawanmesoace� <br /> CONTRACTOR Je� J ( V�=�n� L 8 i Lic.# COE Bus.Lic.# <br /> Address PhcnelEmail <br /> TENANT BUSINESS NAME CONTACT FOR pERMIT ���F � g�„�c v� <br /> J���Gt�t[Jl.��e,�r e�-c'�/�.7iJe, �o.M <br /> Phone/E-mail `Z -Yi �COC� <br /> BUILDING PERMIT APPLICATION CONTRAC7 PrtICE OF WORK G�CL� —' <br /> Existing Use of Building �e� �/�IlC2- HEAT SOURCE: <br /> Proposed Use of Building �e�\ (YE�1C� Gas'�Eiectnc_ O�her_ <br /> Building lype: �ngle Family _Duplex_Townhouse _Mulli-Family _Commercial <br /> Type of pro'ecC New Addilion Remodel �Repair T.I. Si n Sprinkler �Demoli�ion '�han e of Use <br /> DESCRIPTIONOFWORK(addi�ionalspacepr idedonthoba 1: /j �, � �., <br /> ��f=SrGt- 't- �IOvS/�'1- �dn i.ui'��IY1 C6L�Q. C�Cl1\f��l4�1C2 �/IG�U1Q/�f�I[�' N� I <br /> o-� Si<��� 3�.c,Y� U'cJnl4•it�i O'� i •4l�i �i��{ l�f�['i'1 ��llc�(�vl C Cc� <br /> o't��rcw�7c �a�ti�� (-�-"��a�� o� Ce�Lv�Ce� C'�G�J<. t� � c��c��ic��� /S i e� <br /> . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProject: _New_Addn _Alleration_Repair TypeotProject: _New_Add� _Alleration_Repair <br /> Show Numbcr/N1 0//irNres Show Number�11)o!flrtures <br /> AIC-nirhandlingumis � Toilet <br /> Farced air systems I Bathtub <br /> Gas pipinq � Lavato (wash basin) <br /> Waier heater I Shawer <br /> � Gas freplace Kilchen sink 8 disposal <br /> Gas rnn e � Dishwasher <br /> Clolhes d er I Clolhes washer <br /> I Range hood I Water healer <br /> i Eahaust fan I Sink(serviceNar/moplela) <br /> I Heat pump I Backflow prevenler <br /> I Unit heater I Urinal <br /> Boiler Drinkin Fountain <br /> Refn9eralion �I Floor diain <br /> Woods�ove � Grease trep <br /> � Ductin Root drains <br /> � Olher I Medical Gas <br /> SPRINKLER / SUPPFZESSION SYSTEM I Other: <br /> Number of Heads � Other: <br /> I ri�.:�eLy eeNly tnat I have read an�evan�,inud Inu apiv��caeun an�6no++me same la�e vuc an.�,ccnecl.AI�O�a��s�ons ol laws antl orCmances Boveming N�s rype o�wo�+x+U he campl e� <br /> �.,n nrettier specA�ed hore�.n or nol.The 9ranl:ng u�a V�m�.�t ooes nol pmsume m grve a W noury lo violale ur wnu:l the prov��swn ol any other siala or lowl Ww regulaMy co�sVUC�.on <br /> inal I am aulhorized by No ovm 011�is prOpC�y IO pe�am�Ihe wo�k lor wh2h apGl<a0cn i5 maCC BnE I comON�'��he Slata CaniratloR Law 18.27 RCW dntl 296.200A WAC. <br /> / L— ^ <br /> /'- �- � / `��1�-f <br /> �OwnerlAull�orized Agent Signature <br /> � Da1e (Rovised 62012) <br /> �/2 <br />