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�ERMIT AI'PLICATION <br /> F3UILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF kVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPIIr.pTIONS pRE ACCEPTED FROIA 8 AM TO 4 PM I `- ��—� � <br /> SITE D� SS: r • i /, l J PROPERTVTAp%p P, RMITM <br /> � � -�� 28L i� 00��H 30U ��� .—C� ) <br /> LEGAL for nen wnsWdion'. Short PlaVsubdrvision '� Lot No._ (at1aU copy of long legal descnp�ion) <br /> �. <br /> r� ) �` �. <br /> OWNER - J -�l �� Phone/E-mai � <br /> i . ,i , <br /> ' / ' ��` City/StalelZip ' .t �j ��' <br /> Atltlress � ' ��� � <br /> APPLICANT:_Owner OwneYsAent Conlractor ContraclprsAgent��enaM�m�ano+�eenbne�oico�.�oo-an,m6o.�<neeo.wn�,mewa�i <br /> — T � .:' <br /> CONTRACTOR G,� � � � / ������/# � f � � C E Bus.Lic.# � ; -� � <br /> Address �� � � � ��, �l I C'.'• � `% � (. L P�onelEmail <br /> TENANT USINESS NAME ONTACT FOR PERMIT <br /> � ) / / <br /> L� � + , . C~ � Phone/E-mail ((���� � C�L � (C-; <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ _ 7 C'�t' <br /> Exisling Use of Bui'ding � � HEAT SOURCE: <br /> T <br /> Proposed Use of Building � Gas_ Eiectric._ Oiher_ <br /> Building lype: _Single Family _Duplex_Townhouse _Multi-F�amily � ommercial <br /> 7 Ge of pro'ed: New Addition Remodel Repair /fil. Si n Sprinkler Demolition Chan e of Use <br /> � � . <br /> DESCRIPTIONOF ORK(ad trona�spac provid�do fhoback):. ' <br /> . --, <br /> . ! � <br /> ti��� - �f"�,;� t�� �,j ��L � �,�<<� ����� ._ ;. � f��,; �- �.�-u. <br /> . , <br /> �---��-�-� T�7� -���-i� � � <br /> / MECHANICAL PERMIT APPLICA ION PLUMBlNG PERMIT APPLICATION <br /> 7ype ol ProJocl: _Now_Addn _Altcratlon_Ropair Type ol ProJect: _New_Adtln _Alteration_Rupalr <br /> Show Number(N)ollixfures Shaw Number(#)o/llxtures <br /> AIC-air handlin units Toilet <br /> Forced air s stems Bathlub <br /> Gas pipin Lavatory(wash basin) <br /> Water healer Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gzs ren e Dishwasher <br /> Clothes d er Clothes washer <br />- ftange hood Water heatet <br /> Exhaust fan Sink(servicelSar/mop/elc.) <br /> I Heal pump BackOow preventer <br /> Unit heater Urinal <br /> I Boiler Drinki�i Fountain <br /> � Refri eration Floor dram <br /> � Woodstove Grease trap <br /> I <br /> Ductin Roof drains <br /> Olher � Medical Gas <br /> SPRINKLER / SUPPRESSION SYST�M Other: <br /> Number of Heads Other: <br /> I heieby ceit.�ly ihal I�ew reaE antl esamino0lhis appliwlan nnd know I�o sume to�e We anC cpmcl.AA p�ovisbns ol laws and ortlinunces gavembB�Ns type olwurk wtll�e mmpliea <br /> w.Ui wfrelhor speafretl nero�or nol.T�o praniv�B a�e pertnit tloes not pmsumo lo Btio aut�onN lo vo4�lo or wncel t�e pmvision of any othr.r s�ate or bcal Wv rcgulating mnslructwn <br /> Innl l am nuNo�zea eY��e ovmer of lM1is pmpeM�o petlortn I�e wotk brwTich appliration n matlo and I comply wIn Ilie SWte Comradors Law 18.P RCW anE 2'JC�IOOA WAC. <br />- "--���,( C CL; , �.� ,,�� �_ <br /> I _ _ � , y <br /> OwnorfAuthodzed A9ent 9�goatur�� Dale (Revisetl N20tt) <br /> tl� �� <br />