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� � <br /> � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUM�3INGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everefl,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADD[tESS' � QS)G ^y PRO4ER7Y� 0 ' PERMIT N `O <br /> V—1 0 <br /> LEGAL lar new constNcllon: ShoA PlaVsu6Clvlsion Lot No.� (ettach copy ot lang legal desalptlon) <br /> OWNER /�jt�'�� PhonelE-mall . � IS 7G"�� <br /> aaresg O i�7 / a�% Q ClrylStatelZiP /'�0 J'�/�� l'��� �7� <br /> CONTRACTOR L 8 I Lic.# <br /> '-/ Phon�JEmail " Z ZZi <br /> ddte6s Q32f I !✓r �✓f <br /> TENANT BUSINESS AM CONTACT FOR PERMIT <br /> Phon�JE•mail <br /> BUILDING PERMIT APPLICATION CONTRACT PrtICEOF WORK <br /> Existing Usa af 8uilding � HEAT SOURCE: <br /> Proposed Use of Building ���'— Gaa ElectAc'f Otner <br /> Building type: .,�Single Family _Duplex_Townhousa _Multi-Family _Commercial , <br /> Typa ot projacl: _New _Addition _Remodel _Repeir_T.I._Sign_Sprinkler_Demo�lCh�4iQUse <br /> DesCrfptlon of Wofk(addifional space proNded on fhe back): �pyl�il,/ O� <br /> �f/li f`jZ r- 1 was u,gd, <br /> Have you startad working without a permit4 YES �NO . r <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypaofProJed: �New_Addn _Allerallon_Repelr TypeofProJect: _New_Addn _Albntion_Rapair <br /> ShawNum6er(p)o/Ilxfures ShowNum6er olflrfurea <br /> A/C-airhandlin units _ Toilet <br /> Forced air s stems � Bathlub <br /> Gas i in _+ Lavato wash basin <br /> Water hea[er � Showar <br /> � Gas fire laca ; Kitchen slnk&dis osal <br /> Gas ran a <br /> � Dishwasher <br /> Clothes d er Clolhes washer <br /> Ran e hood <br /> � E�chaust ian Sink servicalbar/mo /etc. <br /> Heat um BackBow reventar <br /> Unit healer Udnel <br /> Bailer Drinkin Fountain <br /> Refri eratton Floordrain <br /> Woodstove Greasa tra <br /> Ductln Roof drains <br /> Olher Madfcal Gas <br /> SPRINKLER/SUPPRESSION SYSTEM other: <br /> Number of Heads Olher: <br /> I hereby certiy Ihal I have read and ezamined lhis appliwtlon end knm+��he sama lo be lrue and correcl.All provisbns of laws and ordinances 9oveming <br /> th�q type o1 work vrlll be complied with whether specifed herein or not.TAe pranting ol a permil Cces nol presume�o glve autlwrity to Wolate or wncel <br /> the provislon of y other state or laal law reBulaling constructlon or Ihe peAormance of constructlon.That 1 em aulhorized by lhe amer of;hia properry <br /> to peAortn ihe for which applicalion Is mede antl I compy wilh ihe Slata Cont�aclors Lew 1827 RCW and 298.200 WAC <br /> I — ,- L_ ,Reh,ed Y20,,,� <br /> OwnerlAulho x nnt Signature Data <br /> I �i <br />