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� -, <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERlDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 425-257-8810 FAX A25-257-8857 www.everettwa.org <br /> (��L 42O APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SIT ADD ESS; PROPERiYTAXp PERMIT# �'M� <br /> G13 5k�'��� •�'n� � fi 3 �SYl9G� rcC i,cC v�� <br /> LEGAL for new constmclion: Shorl PI Vsubdivision �IL �`f1�t �� � Lot No� (allach copy of long legal descriplion) <br /> 1 �1 � <br /> OWNER U�'(� f,Y� � ���ikn,: PhonelE�mail .y"�J 1-�Z2L nt< . pL�n�Yle��;�, ��.�� <br /> Address ��;1�? N�� ��+� �v�� CitylSlatelZip :i��1��N15� �^��\ �Zy ' <br /> APPLICANT:�Owner OwnersAgen� _Conlractor _Conlractor'sAgenl _Tenant(���s�pr�reeomr,aroimru�ni�mmi^.ec+�enomwoa�nmsspace� <br /> CONTRACTOR �1Vlt� 6��K I��E`�� L 8 I Lic.� �ynL��rUO�>,,,��— COE Bus. Lic.# <br /> Address ��SZ� �IV �� �J? <br /> Phone/Email �� ��,��r1 L'��� <br /> TENANT BUSINESS AME CONTACT FOR PERMIT <br /> PhonelF-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exist: ig Use o(Building ���� HEAT SOURCE: <br /> �rrL Gas_ Eleclnc Other_ <br /> Proposed Use of Building ✓ � <br /> Building type: �Single Family _Duplex_Townhouse _Multi-Family _Commerciai <br /> Type of project: . New _Addilion _Remodel _Repair_T.I._Si n Sprinkler_Demolilion_Change o(Use <br /> OESCRIPTION dF WORK(additional space provided on fhe back): <br /> �f��'�% ��'— <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoolProJocl: -}y^Now_Addn _Altnral!on_Ropalr TypoolPro)oct: yy`Nuw_Addn _Altoration_Repair <br /> Show Numbcr(p)o//ixfures Show Number/it)o//iztures <br /> A/C—air handling units 3 '� Toilet <br /> Forced air systems I Bathtub <br /> Gas piping 1 I Lavalory(wash basiN <br /> Waler heater i Shower <br /> � Gas freplace f I Kitchen sink&disposal <br /> Gas range I � Dishwasher <br /> � Clothes dryer { Clolhes washer <br /> Range hood � Water healer <br /> Exhaust fan I Sink(servicelbar/mop/elc.) <br /> Heal pump I Backflow preventer <br /> Unit heater i Urinal <br /> � Boiler I Drinking Fountain <br /> � Refrigeralion 1 Floor drain <br /> Woodstove I Grease trap <br /> � Ducting I Roof drains <br /> � Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Other: <br /> � Number of Heads i Other: <br /> I here6y cM�fy l�at I havo read nnd examinud Ihis appfcation antl knmv Iha sama lo bo Irua antl correct.All pmvisiona ol lawe and ordlwncee goveming Ihis typa olwcrk vn!I Ca comp:ieC <br /> r.,h whether sDec�eE herein or not.Tho pmntinB ol a Dermit Com nol pmsumo to Biva eWPordy to violate or wncel Ine pmvision ot eny ot0er stme or Ixal law repulat�g conslruction <br /> �i�al I am authotlietl by Iha oxnM of Ihle pmpetly lo pertortn t�e wark b�xfilch appliwlion b matla anC I mmply wit�Iho Slata Contmdore lew 1827 RCW enE 298 200A N'AC. r/ <br /> E L <br /> � . <br /> ,��� ,, /Zs z- <br /> OamedAu�horizudAgo t gnaluro Dato (Fevised6ROtt) <br />