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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> PROPERTYTAXi( P RM�S � _ <br /> SITE ADDRESS: � � ��'�� � , V � <br /> LEGAL for nmv conslmclion: Shorl PlaVsubdivision Lal No._ (atlach copy ol iong legal description) <br /> � ,.,. �W� PhonelEmail <br /> OWNER ��� A , p <br /> ! � City/StatelZip III;�N!�� '�v` `��r <br /> Address �p'y�S �IY rfi l�i <br /> APPLICANT:_O�vner Owner'sAgenl CONractor _CoNractoisAgent �Tenan�lm�sia�o�;aeaier,ermcc�:��nmmmoow�er�am�o�k�,me<<�:oi <br /> CONTRACTOR I '✓�'• � i1 a� <br /> L&I Lic.# �C�'�� 3��° COE Bus.Lic.# <br /> Address L��/ ��� UC• �� ����'�")`"- ���� �J� `I� PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhoneiE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �D•'� <br /> � HEATSOURCE: <br /> Existing Use of Building <br /> Gas Eluctric_ Other_ <br /> Proposed Use of Building — <br /> Buitding type: _Single Family _Duplex_Townhouse ,_Multi•Family _Commercial <br /> Typeo(project: __New ,_Addition __Remodel _Repair_T.I. Sign Sprinkler,_Demolition_Change ofUse <br /> DESCRIPTIONOFWORK(additionalspaceprovidedontheback): ' <br /> � (;, /���� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProjecl: _Now_Addn _Alleratlon_Repair TypoafPro)ect: _Ne�v_Addn _Alteration_Ropair <br /> Show Num6cr(N)ol/ixNres Sbow Num6cr(N)ol lixtures <br /> A/C–air handling units � Toilet <br /> Forced air systems � Bathtub <br /> � Gas piping I Lavatory(wash basin) <br /> Water heater i Shower <br /> � � Gas�replace � Kilchen sink&disposal <br /> Gas range � Dishwasher <br /> � Clothes dryer I Clothes�vasher <br /> Range hood � Water heater <br /> Exhaust fan I Sink(servicelbar/mop/e1cJ <br /> Heat pum � Backflo�v preventer <br /> � Unit heater � Urinal <br /> Boiler I Drinking Fountain <br /> � Refrigeration I Floordrain <br /> Woodstove � Grease trap <br /> Ducting I Roo(drains <br /> � Olher � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Olher: <br /> � Number o(Heads � Olher. <br /> 1 hereby cert�,fy�hal I havo read,nd eRamined Ih�s aFF�icotron ond knmv tho somo la bo trua and cormU.NI pmvisions ol laws and ord��nances 9ovem�ng Ihis lypo oiwoB xdl6o eompl�ed <br /> wah r:hethe�sFeni'�cd herein or ncl.The 9mnting of a permd tloes nol presumn lo give nul�oriry lo violate or wncel the pmvizian ol any other stata ar local law�epulating construction I <br /> That I am aW��crized hy Ne o�aner cl ihis prepeity to rtortn tha work fer whlch appliwllon ie made end I eampy wii���o Slato Contmetore La�v i8.Y7 RCW and 298200A WAC. 1 � <br /> ��� ������Li .o <br /> ,.,...,, cnn�o� <br />