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I <br /> PERMIT APPLICATION <br /> BUII_DING.!MECHANICAL/PLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERElT PERMIT SERVICES <br /> 3200 Cedar St., Eve;ett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � `�a� �� 7— <br /> SITEADDRESS:� Dd PROPERNTA%p R � 1 <br /> � / <br /> LEGAL for new wnslruction: Shart PlaVsubdivision _Lot No._ (attach copy of long lepal descdplion) <br /> OWNER , �lJ � �n PhonGEmail <br /> Atldress City/5tate/Zip �7/ 0 <br /> CONTRACTOR h� L 8 I Lic.# L�//.�.� <br /> Q�/�� L � L nGEmail T��—?s�[0 0" 5 V�1 Al, � ��. <br /> ddress 00(/ C� IKKI <br /> TENANT BUSINESS NAME CONTACT F�R PERMIT Cp� <br /> PhoneJE•mall - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � <br /> Exisling Use of Building HEAT SOURCE: <br /> Proposed Use of B 'Iding cas_ Electnc__ Other_ <br /> Buiiding typ�: �ingle Family _Duplex Townhouse _Multi-Family _Commercial <br /> Typeofprojecl: _New _Addillon Remodel _Repair,_T.I._Sign_Sprinkiar_Demolilion_Cliange ofUse <br /> Descritionof ork(_eddif\nal�sp4a'�prov`ld�donf�D�k): 1 . � � ��Iw / .I —, � <br /> ,.�,.,.. <br /> co:� ��.1.� �,�V GW��t <br /> �.� tire.� �aMp.`�`.�.�,,^„�'L� / <br /> Have you started working without a permft? _YES v N� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJecl: _New_Addn _Alteratlon_Repalr TypoofProJect: _New_Addn Iterotion_Repalr <br /> Show Number(K1 o/Oxtures Show Number(p)a!Oirfures <br /> A/C—air handling uni�s Toile� <br /> � Forced air s slems BathWb <br /> Gas pipin Lavato (wash basin <br /> Waler heater � Shower <br /> � Gas fireplace Kitchen sink 8 dis osai <br /> Gas ran e Dishwasher <br /> Clolhesd er Clotheswasher <br /> Range hood Water heater <br /> Exhaust fan Sink(service/badmo /etcJ <br /> Heat pump Backflow revenler <br /> Unit heater Ur(nal <br /> Boiler Drinkin Fountatn <br /> Refrigeralion Floor drain <br /> Woodslove Greasa tra <br /> Duclin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM other: <br /> Number o I Other: <br /> I hereby certity thal I hava read and amined t s applicalion end know the same to 6e Irue and correcl.All provisions of laws and ortlinances goveming <br /> this rype of work wi�l 6e co plied«4 whelher ecifed herein or not.Tha granting ol a permit does not presume to give aulhority to violate or cancel <br /> �ho provlslon ol a ' o ep ate or I I law re lating consiructlon or iho pedormance ol consWcllon.That 1 am authonzed by tha owner of this property <br /> rm vro c fo H I i applic tion Is de and 1 comply with the Stale Cont2clors Law 1827 RCW and 298.200 WAC <br /> / ' 1 �V " � <br /> ncrlAuthorize AgentSignaWro Dafe (Revised712011) <br />