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� <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <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 8 AM TO 4 PM /D � aS� I <br /> PROPERTYTA%q P MITI <br /> SITE ADDRESS: _ <br /> 4 I�� <br /> LEGAL lor new consiruclion: Short PlaUsubdivision Lot No._ (attach copy ol long legal desuiplion) <br /> OWNER PhonelE-mail �/ b�- 'L <br /> Address )Z/j — CirylS,ate2lp � <br /> CONTRACTOR � C � �� L 81 Lic.# ic.IC�i 2�� � <br /> Address %� � /� ' ,r 'J PhonelEmail 71p �.5�/O <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelEmeil �G��� `rZ Z6N <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �7Rne — <br /> HEAT SOURCE: <br /> Existing Use of Building <br /> Proposed Use of Building Gas Electric_ Other <br /> 8uiiding type: _Single Family�Duplex_Townhouse _Multi-Family _Commercial <br /> Type of projecl: _New _Addilion _Remodel _Repair_T.I._Sign_Sprinkler_Demoiition_Change of Use <br /> DesCription of Woric(addifional spaceprovidedon fhe back): � ., , <br /> �«a��. 11i.irovr tnnrJfl�J� lU.�YGDN`or!/re,v,,'„i�+i1lrn+e ��yw,�.l <br /> Have you started working without a permit? �.YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJeet: _New_Addn _Alteration_Repeir Type o(ProJeet: ShoweNumbe(M)o/Bxtut�stion_Repair <br /> Show Number(M)0/�xtures <br /> A/C—air handlin units Toilet <br /> Forcedairs stems BathWb <br /> Gas ipin Lavato (wash basin) <br /> Waler heater Shower <br /> Gas fireplace Kitchen sink&dis osal <br /> Gasran e Dishwasher <br /> Clothes d •er Clothes washer <br /> Ran e hood Water healer <br /> Exhausl fan Sink(service/bar/mop/etc.) <br /> Heal pum BackOow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlain <br /> Refrigeration Floor drain <br /> Woodstove Grease tra <br /> Ducting Roof drains <br /> Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. <br /> Number of Heads Other: <br /> I hereby certiry Ihat 1 have read and examVned this epplication and know lhe same to be lrue and correct.All provisions of laws and oMinances goveming <br /> lhis lype of work will be compiied wilh whether speci(ed herein or not.The granting ol a permit does not presume to give aulhority to violate or cancel <br /> the provision ol eny olher slale or lowl taw regulating construclion or lhe peAormance of conslruclion.7hat I am aulhorized by ihe owner of this propeAy <br /> lo perlorm Ihe r for which application is made and I comply wilh the Slate Contractore Lew 18.27 RCW and 296.200 WAC <br /> % ���� (Revised?l2011) <br /> Ownerl lhorized gontSigna Dale <br />