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( � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I —�O `�Z <br /> 51T DD SS PROPERTY TA7f M RMIT R — <br /> ��� - `' n <br /> LEGAL for new construction: Shoh PlaVsubtlivision Lol No._ (atlach copy of long legal description) <br /> OWNER �2P J PhonelE•mail ZS� S n —�n � > <br /> Address CitylStatelZip ve <br /> CONTRACTOR l�� P 1� L&I Lic.N <br /> Address PhonelEmail <br /> TENANT BU31NE33 NAME CONTACT F ' PERMIT <br /> �7�1 (�p s <br /> l — � lT Cvfl.J � ��F_ PhoneiE•maii \G ��e� C� -t fT/� -�{4�0� <br /> BUILDIN6 PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Praposed Use of Building Gas Electdc Other <br /> Building lype: �Single Family ,_Dupl^x_Townhouse _Mulli-Family �Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler,,�Demolilion_Change of Use <br /> Description of Work(eddifional space providad on the back): ����\� 1�v�j� �1 V�C l� 1� <br /> Have you started working without a pemiit4 _YES �NO c�O� ��U- � CM � `��z/ ��'� I <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJact: _Naw_Addn _Alteratlon_Repair Type of ProJaet: _New_Addn _Albntion_R�p�ir <br /> Show Number(MI o1/Ixtures Show Number(N)ol t7xtuns <br /> A/C—air handlin units Toilet <br /> Forced au s stems Bethtub <br /> Gas i in Lavalo wash basin <br /> Water henler Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gasran e Dishwasher <br /> Clothes d er Ciothes washer <br /> Ran e hood Water heater <br /> Exhaust fan � Sink(servicelbadmop/etc.) <br /> Heal pum Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlain <br /> Refri eration Floordrein <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINNLER / SUPPRESSION SYS7'EM Other: <br /> Number ot Heads Other: <br /> I here6y ceAify that I ha��e read and examined Ihis application and know tlie same to be truo and cortecl.All provisions ol laws end ordinences goveming <br /> this lype of work will be complied with whelher specified herein or not.The granting of a permit does not presume to give aulhority to violete or cancel <br /> the provisfon ol any olher state or local lew regulating conslruction or Ihe pertortnance o1 construclion.That I am euthorized by Ihe owner of Ihls property <br /> to perlorm the work for which appiiwlion is made and I compty with Ihe Slate Cunlrectors Lew 1B.27 RCW and 298.200 WAC <br /> �� �,� �t� , �� �� ��� (s�L ��_2.� �a�-�� <br /> OwnerlAuthorized Agent Signature ° ate (Revisad?/2011J <br /> �(�v� A O �Z f.J 1 Z_ <br />