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PERMI�' APPL.ICATION <br /> BUILDINGIMECHANICAL/I�LUMBING/SIGNISf�RINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-2�7-8857 www.eve�ettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 3 "7`�� <br /> SITEADORESS:. <�` CG�PROPERNTARN P�R I N _�)✓ � <br /> � �' �VE,'( � � i - ',`�y' � <br /> �'l 7 <br /> LEGAL for new consimc�ion, Shoh PlaVsubtlivision Lot No._ (aflach copy of long legal descnpiion) <br /> OWNER �� i `�� 't Eil Phone/E�mail ��� ��i"� �c ' � <br /> Address �{Q 2. ' � C ��� Ci�Y/StatelZiP S ' � n, f� �I <br /> APPLICANT:_Owner OvmeYsAgent Coniractor CONracfor'sAgent __Tenant(mm�pm.aoa�eu�roac�:emrrommaw.,�amao»oamnaspaco) <br /> CONTRACTOR —� L -" ; L 8 I Lia# �ull G� � COE Bus.Lic.# <br /> , � S�oz .�c���, <br /> Addres ` 1� �oe� 7i �t�ct� � i� � II ' rno��iem a � '7p� . �� - �� <br /> TENANT BUSIN SS NA E CONTACT FOR PERMIT <br /> P�onelE�mail <br /> BUILDING PERMIT APPLICATION CON7RncT PRICE oF woRK <br /> Existing Use of Building ��'�y HEAT SOURCE: <br /> Proposed Use of Building Gas_ Elednc_ Other_ <br /> B�ilding type: _Single Family _D�ptex_Townhouse _Multi-Family r Commercial <br /> T pe of pmlecC New __Addilion _Remodel _ ' Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> DESCRIPTION OF WORK(atltlifional space p�ovioed on the backi: <br /> ���PC�I(AGI�CC� � <br /> "tf �'iJi L1i'J�- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PFRMIT APPLICATION <br /> TypeofProjecL _New_Atldn _AlteraUon_Repair TypeolPro�ect: _New_Addn _Alteration_Repalr <br /> Shmv Numbcr(q)o/lixfures Show Number(#)a!liMures <br /> A/C-air handling units Toilet <br /> Forced air syslems BatMub <br /> Gas piping Lavatory(wash basin) <br /> � Waler heater I Shov�er <br /> Gas fireplace I Ki�chen sink&disposal <br /> � Gas range Dishwasher <br /> Clollies dryer � Clothes washer <br /> Range hood _ Waler heater <br /> I Exhausl fan Sink(service/barlmop/elc.) <br /> Heat pump Backflo�v prevenler <br /> � Urinal <br /> Unit heater _ <br /> Boiler j Drinking Fountain <br /> tiRefrigeration Floor drain <br /> Woodstove Grease trap <br /> � Ducting � Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM � Other: <br /> Number of Heads Olher: <br /> I h=reCy certdy Ihal I havo iead nnd e.amine0 ths appiicalion ontl know No samo lo Ga Iruo and canecl.NI provisions ol laiw antl orainances goveming Nis rypo alwork��il�o complied <br /> rinM1 wtwther spe—c-i�fied hercin or nol.Tho gmnlinp of o pem��it does nol presumo lo givo nN�ony to violale or cnncel lho provision ol nny oNer slala or local law regulaling construclion <br /> Tha�I q(n aNho6xetlAy Iho owner ol l�is pmperry lo pedortn t�e wo�k for wMc�applicaLon is maCe end 1 compy wAh lhe Slale CONraclors Law 10.27 RCW anE 298200A WAC. <br /> , <br /> �, � <br /> i f 2 <br /> � � . ����.. � ,�/�I �% <br /> OwnerlA'����o��?d�������ure � Daie (Revisetl 6/2072J <br /> ��� ___—_ _ - _ _ <br />