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PERIVIIT APPLICATION <br /> BUILDINGlMECHANICALIPLUMBINGISIGNISPRINKLERlDEMOLITION <br /> CITY OF =VERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 -425-257-8810— FAX 425-257-8857—www•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TA%!1 P RMIT# <br /> ZZ26 t^oM13AR�D A��E �� i 1 i:�'Z-"��. <br /> LEGAL for new conslruclion: Shorl PlaVsubdivision Lol No._ (altach copy ol long legal descriplion) <br /> OWNER 21-,EtJE 5\MP�F�� PhonelE-mail <br /> Address CitylStatelZip <br /> CONTRACTOR Rry L E R-Oo�jz„ L&I Lic.# (LESCIA(L� OO�T <br /> Address ;1S 20� iZ-D• SW SrE- tDl Pk��F�� �Fl� �Q�'�� Phonc/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail J0� �� ' zS3 "�-10 -7349 <br /> BUILDING PERMIT APPLICATION CON7RACT PRlce oF wORK � I 600=' <br /> HEATSOURCE: <br /> Existing Use of Building <br /> Proposed Use of Building Gas_ Electric� Other_ <br /> Building type: X Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type o(project: �.New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Descfiplion of WOfk(addifional space provided un Ihe back): <br /> 51JSrA�t, rJE�1 W/�rEQ FFEArE2 <br /> Have you started working without a permil7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Pro)ect: _New_Addn _,Altoratlon_Repair Typa of ProJect: LNew_Addn _Attoratfon_Re�ait <br /> Show Num6er(N)o/lixtures Show Number(N)o!lixtures <br /> � A/C-air handling units � Toilet <br /> � Forced air syslems � Bathlub <br /> � Gas piping I Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clolhes dryer Clothes washer <br /> Range hood I Water heater <br /> � Exhausl fan Sink(service/bar/mop/etc.) <br /> Heat pump � Backtlow preventer <br /> � Unit healer � Urinal <br /> Boiler � DrinAing Founlain <br /> �-- Refrigeration Floor drain <br /> �-- Woodstove Grease trap <br /> - Ducting � Roaf dreins <br /> � Medical Gas <br /> � Olher <br /> 'I SPRINKLER / SUPPRESSION SYSTEM Other: <br /> INumber of Heads I Other. <br /> I hereby certity that I have read and examined this application and knnw Ihe same to be Irue and correcl.All provisions of laws and ordinances governing <br /> this type of work will be complied with whether specif:d herein or noL The�ranting ol a pemiit does not presume lo give authority lo violale or cancel <br /> Ihe provision of any olher s�a�e or local law regulating conslruction or the pedormance of constmction.Thot I am authonzed by Ihe owner of Ihis property <br /> to pertorm Ihe wo for which applicalion is made and I comply wi�h the Sla�e Conlractors Law 1827 RCW and 2962�0 WAC <br /> 02-11- II <br /> pW���ed A�ont Signaturo <br /> Dale (Revised 22077J <br />