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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8870—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRE�$S: ' I 'I PROPERtt7A%k PE ITp � � <br /> Z 2 0 1 f�iV r tY `� f�G P' . �� <br /> LEGAL lor new construclion: Short PlaUsubdivision Lot No._ (altach copY ol long legal descnption) <br /> OWNER OW�1 0"/WI� CY�✓71 � �,(� Phone/E-ma��l ¢Lri- 2 S"1- 2vnv <br /> Address 'LZ a"�Vt/'G Gry�SlalelZiP CrLT" YY`� ���� <br /> CONTRACTOR 1..�1.�hlL�' L 8 I Lit.# <br /> Address PhonclEmail <br /> TENANT BUSINESS NAME CONjl��v'O,R PEFjM11i�� 1 ti� — <br /> Ph Y/ t�/ i-i <br /> /E�mail`` I� L — �7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `=" <br /> Existing Use of Building �� HEAT SOURCE: <br /> Proposed Use of Bvilding�V rLh Gas_ Eicctnc_ Other___ <br /> Buildingtype: _SingleFamily _Duplex_Townhouse _Multi• amily _Commercial <br /> T;�,,ealprojed: _New _Addilion _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change olUse <br /> Descriplion af Work(adddional spaco pov"ded m Mo Dech1: <br /> Grmv�.k �t�s�v �i,F. �nt�� �c��� �pa�c �n� �y✓rcc-�. \ <br /> Havo you started working without a permit7 ,_YES _NO (M�� D LV• �� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT A�PLICATION <br /> Typo 01 Projoct: _Naw_Addn _Alloration_Ropalr Typo of ProJoct: _Now_Addn _Alteratlon_Ropair <br /> Sbow Numbcr(a)ol firtures Sbow Number ryq o/flxtures <br /> � AIC—airhandlingunits I Toilet <br /> � Forced air syslems I Bathlub <br /> I Gas pipinq I lavato (wash basin) <br /> I Waten c�ater I Shower <br /> I Gas fireplace I Klichen sink 8 Aisposal <br /> Gas ran e 1 �ishwasher <br /> I Clolhes dr er � Clolhes washer <br /> � Ran e hood I Water heater <br /> � Exhaust fan ! Sink(service/baUmopletc.) <br /> � Heat pum i Backflow preveNer <br /> I Unit hea�er I Urinal <br /> � Boiler I Drinkin Fountain <br /> � Retri eralion I Floordrain <br /> � Woodstove 1 Grease trap <br /> i Ductinq I Roof drains <br /> ' Othcr � Meditat Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> '� Number of Heads I OU�er. <br /> I hereby cetldy Ihat I havo read and examined Ihls applicauon and know tne same to ba true and corrett.NI provisions ol lam and oramances goverNn9 <br /> ihis lypo ol wIXk will bo tompiiCd with�Niether sPecilied herein W noL Ttw g2ntirg of a{wrmit dces trot presume lo give au:ho��ty tu v�o!a:e or cancr.l <br /> eneprovisiono�eny rsta orbcalWwregulatirgeonstruetianorNepeAormanwofeo�slruetion.ThallamauttwrizMfb�tne��nnrrotin�,sp�c,;�eny <br /> !o pcAo Mo for whlch pplicalion is mado efW I comply Nilh tho Slalo Contracfors Law 7827 RCW and 29f 2W WAC <br /> �� ( ��2 �1� <br /> oata (R�vucd Z20 r i! <br /> Ownor Autho Zso�ABont Signaturo ' , <br /> l�� <br />