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% <br /> PERMIT APPLICATION <br /> BUILDINGIML�CHANICALlPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> � APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> Y PROPERiYTAXN P RMIT# <br /> SITEAnDRESS: ,� �� 4O� � 2 �0-07-� <br /> LEGAL(or nevi conslruction: Siiort PlaVsu6divislon Lot No._ (ailach copy of long Iegal descdplion) <br /> OWNER � PhonelE-mail � • 7_S2- 3 I 6 � <br /> Addmss 2� CilylState/Zip � � <br /> APPLICANT: Ovmer O�vner'sAgenl CoNracfor Coniraclor'sAgenl _Tewnllmus�woriaenienerorm�semimmme��.r.ermao.�orxmmaspaca) <br /> CONTRACTOR ,�.�L .sv�. ? L&I Lic.# COE 6us.Lia# � <br /> PhonelEmail <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> - /7 o H e ' PhonelE-mail <br /> BUILDING PERMIT APPLICATtdN� CONTRACT PRICE OF WORK <br /> Existing Uae of Building �' � �<- � HEAT SOURCE: <br /> �-`�? Gas ElecUic_ Olher_ <br /> Proposed Use of f3uilding ' `- — <br /> Building type: 1Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel __Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> DESCRIPTIONOQW�O�G(ad�tionals�cepro�dedon� abafk)�S �_ ��� (���ow �N�kY� l �J`" � <br /> N,2.��c�b.•. -,., o,y �5 0 <br /> � � Q, ^� a,�'Jo.r2 <br /> N � ��PQ � �``I <br /> p � N 0.�-�-•- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJecl: _Now_Addn _Aileratlon_Repair Typn of ProJect: _Now_Addn _Alfnration_Repair <br /> Show Nunt6cr�p�ol/ixfures Show Number(N)o/lixfures <br /> � A/C-air handling units ; Toilet <br /> Forced air systems I Bathlub <br />"� � Gas piping i Lavatory(wash basin) <br /> I Water healer I Shower <br /> � Gas fireplace I Kitchen smk&disposal <br /> 1 Gas range � �ishwasher <br /> 1 � Clolhzs dryer I Clothes washer <br /> Range hood � Waler heater <br /> Exhaust fan � Sink(service/bar/mop/elc.) <br /> Heat pump � Backflow preventer <br /> � Unit healzr I Urinal <br /> � Boiler � Drinking Founlain <br /> � Refrigeration Floor drain <br /> Woodstove <br /> � Grease trap <br /> � Duc�ing I Roof drains <br /> � Other � Medical Gas <br /> I SPRINKLER / SUPPRESSION SYSTEM � Other. <br />� I <br /> I Number of Heads Other: <br /> I i.creby mtlrty Ihal I hovo roed and exan�•ined Ih�s appl:cofon ond know Iho same lo bu Ime and eortect.All p�ovisens ol laws antl o�dinances gm�eming Ihls lype ol�voik wi!I ba mmp;�ed <br /> wM whelhe�spec,fed herein cr noL Th•9ranling ol a permit dom r.ot presume to give autOcrdy lo violate cr cnncel tho provis�on ol any ot�er stato o�lowl law mgulaling«nstrunlen <br /> Thal I am aul�orize0 hy t�o o�.vner cl lhis pmpetly lo pedorm iha«rork fofxhich a;F�Icalion is maCo and I compry�a:h Iho Stale Coolractors Law 1827 RCW anE 296200A WAC. I� <br /> n � <br /> � J Y,(h�^v0 9- � � • � �— � � .o_..:....wcnn��� <br /> . � .. . . . . �r— . <br />