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f <br /> 4 <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425457-8857—www.evereriwa.org` z z � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 3 <br /> SITEADDRESS: � PROPERiYTA%N PE(tM1T� -JI I <br /> ��, Y �0 ' <br /> LEGAL for new consi�uction: Shorl PlaVsut]Nision Lot No._ (anach wpy of lorg legal tlescnplion) <br /> OWNER / }� Y1 PhonNE-maB <br /> Address CitylSlalrJZip � � <br /> S =ILv.c..c,7 L� L 8 1 lic.# � 2�KSE `� �•� <br /> CONTRACTOR ' q <br /> � 1 Ou�•7 ��1 �-` - �� S� � pl PhondEmail � �' /� 7 (7 <br /> AdEross <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E+nail <br /> BUILDIA�IG PERMIT APPLICATION CON rruCi PRICE oF woRK <br /> I �-� <br /> Ezisting Use of Building Q f S�A P rr4��a.� HEAT SOURCE: <br /> Proposr.d Use of Building Z1 tS\�.fl�� " � Gas Electric _ Other <br /> Buildinglype: �SinglcFamily _Ouplez_Townhouse Mulli-Family _Commcrcial <br /> Type of project: _New _Addilion _Remodel _Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> D�nplio ofWork(addilionolspacop���ndonfhe ick�: <br /> �C���'1�'CZ.O ��1�- �����- Y c t., l'>�� �'V�i..c,�-'J— <br /> W t�� C zy�*e . "\ -c���—>e�' I r i�- "C \`c E-�'C.� <br /> Heve you started working withoul a perm(t9 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type at ProjecY: _New_Addn _A��antion�Repair Type of Project: _New_Addn _Altenlion_Repair <br /> SM1ow Number(A)�I flxtures Show Number(fl)of flxtures <br /> AIC-airhantllin units Toilet <br /> Fwced air s tems Bathtub <br /> Gas i in Lavato wash basin <br /> Walen c�alcr Shower <br /> Gas fire lace Kitchen slnk 8 dis sal <br /> • Gas ran e Dishwasher <br /> Clolhes d cr qothes washer <br /> Ranoe houd Water heater ' <br /> Exhaust fan Sink serviceJbarlm /etc. <br /> Heat um I Backllow revenle�• <br /> Unit heater Unnal <br /> Boiler Drinkin Fountain <br /> Rcfri cralion Floa drain <br /> Woodslove Grease�ra <br /> Ductin � Roof drains <br /> Other � Medical Ges <br /> SPRINKLER 1 SUPPRESSION SYSTEM Other: <br /> Number of Heads O;her. <br /> I hereby ce�6ry Ihat I have read entl eramined Ihis applicalion ond know lhe sumo to bo Wo and corteR.NI pmvi;lons ol inws and ordinances goveming <br /> this rypu of wurk wlll 6e canplied with whefher specifed herein w not.Tha granfing of e permil daes not posume to give authariry to violale or cancel <br /> Iho pmvision ol eny olher stoto or locel law rugulaUng consWclion w Ihn peMomience of consWcUon.That I am authamad by ihe owner ot Ihis pmperty <br /> lo pedom+th rk fw wfiiU eppliwtion Is mada and I wmply with U�a Siate ConVatlors Lnw 18.27 RCW end 296.200 WAC <br /> � � <br /> � / !�` + ���� Oat/ (Ravisod?120ifJ <br /> O en'�i¢ riz�tl Ayant Signaturo � <br /> ( / <br /> �a <br />