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PERMIT APPLICATION <br /> BUILQIiVG/MEC�IANiCALIPLUMBlNGISIGNISPRINKLEF�JDEIV�OLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 - 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> qpPLICATIONS ARE ACCEPTED FR0�9 8 AM TO 4 PM �I "Z�' �� <br /> PROPERTY TAX q PEFjM1T# <br /> SITE ADDRE55: /�U� EVC f���r �'�� `i�''��j (�n4 3�l L L�f O;2Oi'�i '` //0 � D/ Cv <br /> �g�C L�in1L�f1Rll <br /> LEGAL lor new consimction: Shotl PlaUsubdivision <br /> Lol No._ (attach copy o(long legal descriplion) <br /> OWNER���cki.1/ <<j�f�L'��%�'�`� U�"�V`� PhonelE-mail <br /> Cy25 �10-1349 -£D �inlr:zEniE��c:r <br /> Address �,�1�' u�r'»�7A�� Y���G. CitylStatelZiP EVE�ei:IT �v� 9����'1 <br /> CONTRACTOR ' �' !iL� I� IZ'�.!:i71/.ti'��D L& Ilic.# <br /> PhonelEmail <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR!PERMIT Ly��✓ ��,2���ilrZ�n"� � �`�'�� <br /> .I�:+sL GJc'�r` <br /> ��V�l'c iT G!3 i° r�-J,—E:' > t"� iC' '� phone�E-mai� 415��1-s.z' Zl S 3 <br /> BUILDING PERMIT APPLICATION <br /> CONTRACT PRICE OF WORK �3 U��� <br /> /'Li��L OFFrGc� HEATSOURCE: <br /> Existing Use of Building C�F <br /> Proposed Use of Building <br /> �1�j/,J�-C14 L �h !– lGC Gas_ Electric_ Other_ <br /> Building type: _Single family _Duplex__Townhouse _M�u/lii-Family �Commercial <br /> Type of project: _New _Addilion _Remodel _Repair /� T.I._Sign_Sprinkler_Demolition_,Change of Use <br /> DesCription of Work(adddional space provided on the 6ack): . �. .1,�,i ���� A,,� /C/,V�;;��r �� <br /> ti��� ��i�i75 �,/!?;.L; , pC:��> , A.'J��) �G��'F5 i o �P>C L <br /> i �i� <br /> Have you sWrted working without a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alleration_Repair 7ypo of Project: _Naw_Addn _Alleration_Repair <br /> Show Number�#)o!fixtures Show Number�J!)o//ixtures <br /> � NC–air handlinq unils Toile[ <br /> � Forced air systems I <br /> Bathtub <br /> Gas piping lavatory(wash basin) <br /> Water heater Shower <br /> Kitchen sink&disposal <br /> Gas fireplace � Dishwasher <br /> � Gasrange � Clothes washer <br /> � � Cloihes dryer � Water heater <br /> Ranqe hood � Sink(service/badmopletc.) <br /> � � Exhaus!fan � Backfiow preventer <br /> Heat pump � Urinal <br /> j � Unit heater <br /> Drinking Fountain <br /> � Boiler � Floor drain <br /> � Refrigeration � Grease trap <br /> � Woodslove � Roof drains <br /> � Ducting <br /> � Other_ Medical Gas <br /> ' SPRIAdKLER I SUPPRESSION SYSTEM Other: <br /> I Number of Heads <br /> I Othec <br /> � I hereby certify Ihat I have read and examined ihis application and know ttie same to be Ime and correcl.All provisions of laws and ordinances goveming <br /> O�,is lype of wurk will be complied vn�h whether specified herein or noL The granling of a pertnit does nol presume to give authoriry lo violate or cancel <br /> tne provision ot�my other state or lo law regulating construclion or lhe pe�tormance of construction.That I am authorized by the ovmer of thls property <br /> to pertorm Ihe wurk for vfiich applic/IiOn is made and I comply vnth Ihe Slate Contractors Law 10.27 RCW and 296200 WAC <br /> r� <br /> �"' � i/,� �'in��,�.2��1 <br /> r— (Revised 22017) <br /> Own,rNAuthorizad Agent Signa/ e ���0 I <br /> � 7 <br />