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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMQ�LI710N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—vwvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDR SS: • 1 PROP�RTYTA7f,11 PERMIT R ' <br /> Oi a oCA h1t �GLS� L 0�' 101�d� <br /> LEOAL for new construcllon: Short Plat/subdiv slon Lot No. Z� (attach copy of loip lepal desuipllon) <br /> OVYNER � PlwndEmall 'V <br /> ad��a 1 y q ciry�s�e�e�zia Huu�N+KI �Jt� fj24 <br /> CONTRACTOR A��� L&1 Lic.# (�, <br /> ddress ],S I WT F� Phor�elEmail � iu <br /> TENANT 8 SINESS NAM CONTACT FOR PERMIT <br /> PMnelE�mail �Yn�'� ��0 . �v <br /> BUILDIN�i PERMIT APPLICATION CON7RACT PRICe oF WORK <br /> Exisling Use of Buiking �f�— HEAT SOURCE: <br /> Pfoposed Usa of Bulld(ng S�� Gas Elecir{c Other <br /> Buildingtypa: ,�QSfngleFamily _Duplax_7ownhousa _Multi-Famity _Comrtrorc,ial . <br /> Typaotprojed: _Naw ,_Addition _Remodel _Repair_T.I._Sign_Sprfnkler_Demolitfon_Change otUse <br /> Desulptlofl o(Work(addifional space povfded on fha backJ: <br /> ��'Pw S�r�- <br /> Havayoustartedworkingwithoutapermit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJect: _New_Addn _Allerotlon_Repalr Typao(ProJect: _New_Addn _Altention_Repeir <br /> Show Number(it)of/lxtures Show Number(NJ ol flxfuns <br /> AIC–air handling units Toiiat <br /> Forced air s stems v Bathlub <br /> Gas i tn Lavato �vash basin) <br /> Waler heater I Showar <br /> Gas fire lace / Kitchen sink 8 dis osal <br /> Gas ran e i Dfshwesher <br /> Ciolhesd er � Clotheswasher <br /> Ran e hood <br /> Exhaust fan Sfnk servicelbar/mo /etc. <br /> Heat um Badcflaw reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Fioor drain <br /> Woodstove Grease tra <br /> Duclin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM othar. <br /> Number ol Heads Other: <br /> I hereby cerliy thal I have read and examinetl this applicallon and know Ihe same to ba INe and correct.All provisbns of laws and ordinances goveming <br /> Ihls rypa of xrork will be com lied with whether specified herein or not.The g2nting of a permit dces nol presume to give auNMly to violale or wncel <br /> Iho provislon ot any other st e o�laal law regulaling cons�rucllon or lhe peAormance of consWctlon.That I am authorized b/tl�e owner of lhie properN <br /> to peAorm l�e vrork for which plicellon Is mada and 1 compy with Ihe Slate Cont�actors Lew 18.27 RCW and 298.200 WAC <br /> � �j' �� <br /> OwnerlAuthodzedAgun i � Wtt Oate (ReWsed:/2011) <br /> Y `�� <br />