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( <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBINGISIGN/SPRINKLER/DEMOLITiON <br /> CITY OF EVERETT PERMIT 3ERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8&10—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM "I <br /> SITEADDRESS: PROPERTYTAXN PERMIT• _ <br /> � 2'LS LOM1�R� PcV� O tl ' O �c7JD1 30�0 <br /> LEGAL for new construction: Shoh PlaVsubdivision E1�F0-�l �N�la.5 17%JyJ)Lot No.���� (altach copy ol long legal descriplion) <br /> OWNER (�EI, 4\(1�td.N(, ll- FR— Phone�E-mail �-Z7'���'�O ' <br /> Address p b��= fkU� tJ� City/Slale/Zip Q � v�/a �'8a7Z <br /> CONTRACTOR SLL� mCS a�G . L 8I Lic.# <br /> Address lO�o�( I ���A `-� t O�i PhonelEmaii �j- g-1p�CJv f '�`y <br /> TENANT BUSINESS NAME CO�TACT�OR PERMIT � <br /> � � Phone/G-mnil <br /> BUILDING PERMIT APPLICATION CON'!itACT PRICE OF WOR � ovo <br /> ExistingUseofBuilding�S t'�L� HEATSOURCE: <br /> Proposed Use o(Building ��t 7���X� �� Gas� Electnr.� Olher_ <br /> Building�ype: LC Single Family _Duplex_Townhouse _Mulli•Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair,_,T.I._Sign_Sprinkler_Demolition�hange of Use <br /> Description of Work(additional sp�ce provided oNthe back J U�'r I� p���� ` <br /> M� �u� U11�( �L 9 �1 �� � <br /> Have you started working without a permit7 _YES �NO l�1ClZl4�(,: w EX�51� S�JI�IN4r�+'��� <br /> MECHANICAL PERMIT APPLICATION PLliMBING PERMIT APPLICATION <br /> TypeofProjoct: _New_Addn _Altoration_Repair TypootProJact: _Now_Addn _Alloratlon_Ropair '� <br /> Show Number(p)of(ixturcs Show Num6er(M)o//Ixtures <br /> PJC-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavato (wash basin) <br /> .;� Water healer Shower <br /> Gas freplace / Kitchen sink&disposal <br /> Gasrange Dishwasher <br /> Clothes dryer Clothes washer <br /> 1 Water heater <br /> Range hood <br /> �� Exhaust fan � Sink(service/bar/mop/elc.) <br /> Heat pump 8ackflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeretion Floor drain <br /> Woodstove Greasa trap <br /> Ducting Roof dreins <br /> Other I�ledical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby cerlify that I have read and ezamined Ihis applicallon and know Iha same to be irue and canect.All provisions of laws and ordinances goveming <br /> this lype ol woi,,will be complied with whether specified herein or nol.Tha granling of a pertnit does nol presume lo give authority to violate or wncel <br /> the Frovision of any other slale or local law regulating conslrucllon or the peAormance of consWction.Tha�I em authorized by t�e owner o1�his propedy f��� <br /> lo peAorm Ihe� ork f r which a plicalion is made and I compl�wilh Ihe Sl�ite Conlractors Law 78.27 RCW and 296200 WAC <br /> � , 'j 11 <br /> Ownor/Autho ed gontSigna ro 7a�e (Revised711017) <br />