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� � <br /> PERMIT APPLICA,TION <br /> BUILDINGIIVIECHANlCAL/PLUMBING/SIGN/SPRINKLERIDcMO�ITION <br /> CITY OF EVERETT PERMIT SERVICES � � a�� �3 <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 3 o I- o�3 <br /> SITE ADDRE55: ^^ VROPER7YTAX N PERMIT# <br /> .SE V i�.�.Kl��. w� 'ZJ.� <br /> LEGAL far new consimc!ion: Shotl PlaVsubtlivision Lot No._ (altach copy of long legal description) <br /> OWNER PhonelE�mail <br /> . Address `Z-.C7 � V ( . � `-� \ �'� CitylS�a�e/Zip <br /> APPLICANT:_Owner OwnefsAgen� ,LCon�rac�or _CaniractoPSAgent TenanlcR�us�vm.aaa�e;:e�orcm:emr.omiuw+�e��oe�wo�k���maspa�nl <br /> CONTRACTOR Y " �1 C.GrI. � ' c's S � ' L&1 Lic.# COE Bus.Lic. # <br /> P,ddress Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT�/�� <br /> / J „_,i <br /> ����� ��;A`� �������� PhonelE�mail 7 ] � � <br /> BUILDING PERMI RPPLICQTION CONTRACT PRICE OF WORK <br /> Exisling Use of Building / HEAT SOURCE: <br /> ' Proposed Use of Building �'�'I I�'�� � Gas_ Eleclric_ Other_ <br /> Building type: __Single Family _Duplex_Townhouse _Multi-Family �Commercial <br /> Type of projecl: New __Addilion _Remodel _Repair_T.I._Si�n_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space providedon theback/: � <br /> ��,v �(� �,�-�c,l �nr7 k�� 1� `�t'��vv�5 , ,-A�l�c1C <br /> vc� ' � <br /> ��� �� � ���� <br /> MECHANICAL PERMIT APPI.ICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: _New_Addn _Allerotlon_Repair 7ype ol Project: _New_Addn _Alteratlon_Repair <br /> Show Numbcr(p)o/lixfures Show Number(b)ol flxfures <br /> AIC—airhandlingunits I Toilel <br /> Forced air systems _ � Bathlub <br /> � Gas piping Lava�ory(wash basin) <br /> • Water healer � Shower <br /> Gas(ireplace Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clo�hes washer <br /> � Range hood Water heater <br /> Exhaust fan Sink(servicelbar/mopletc.) <br /> � lieal pump � Backflow preventer <br /> Unit healer Urinai <br /> 6oiler Drinkin9 Foun�ain <br /> � Refrigeralion Floordrein <br /> Woodslove � Gieasetrap <br /> � Ductin Roof drains <br /> ' Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number of Heads Oth?r: <br /> i I�ere�y certtly thal l haue read anE ewmined I�is appiico(ion ana know Iho sama lo be Irua and mrtecl.All pmvisuns of lavrs anJ ordnancea qoveming Nis rype olworkwiA be complied <br /> e:m�vihel�e�specibetl Perein or nol.The granlin8 o!a permil tlom nol presume to pko aul�onry lo violale or cancel I�e pmvision ol ony othet sUto or local law re8ulatmg consliuctlon <br /> inat I nm oulhotlzeE Ey tho own o�Ihis pmpe�y to pertorm Iha vmik forwnich aDPlAalion ia matlo and I comply w4h No Slate CoNractors Low 7827 RCW antl 290.POOA WAC. <br /> Own.dAi��d A�ent Signat� //� (Rersed G/20721 <br /> —__ -- <br /> —_ —__. __ . __.__ _ ' <br /> ,�,_.,..,. .. <br /> .�: �...m,.. _ . <br />