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r � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, lNA 98201 -425-257-8810—FAX 425-257-8857—ww�v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM �I 7-- <br /> SITEADDRESS: PROPERTYTAXp PE IT# <br /> �32� i LO/.1Cd`3�� ��� Cl�EJ2E?� 001�[3 / 9(�3 -3�J � <br /> LEGAL for new cans�ruciion: ShoA PlaUsubdivision ��-�K �7 T O'C OLaI N�� (altach copy of long legal descriplion) <br /> OWNER �TE(�� �$//LL/�`�-1 Phone/E-mail Lf � l�� ' ��y� . <br /> Addres�i/ �� ���j 1T S�.C3 Ci�ylSlale/Zip (`�NN�✓�� W�1 /O �J v <br /> CONTRACTOR �'��E� L 8 I Lia# <br /> Address PhonelEmall <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail � �-�D/ — �� y 7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK D00. _ <br /> Existing Use ot Building�S'J��G� �wN 3'j�}I'Q� � Q� • HEAT SOURCE: <br /> Proposed Use of Building Z x �'9�'�� 'E' Gcs_ Electric_ Other_ <br /> Building lype: �ngle Family _Duplex_Townhouse _Mulli•Family _Commercial <br /> Type of pruject: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_ emolition_Change of Use <br /> Description of Work(edditional space provided on fhe back): �ST�c.�r T� O�v <br /> �E�fJ��E �1N�,or,erliT�O CO� . <br /> Have you started working without a permltl _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Projncl: _Now_Addn _Altoratlon_Ropair Typo of ProJecl: __Naw_Addn _Alleretion_Ropalr <br /> Show Numbcr(#)cl/ixtu�os 5 Yow Number(M)o/RxNres <br /> A/C—air handling units _ Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavalo (wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gasrange Dishwasher <br />'� Ciothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(servicelbar/moplelc.) <br /> Heat pump BackOow preventer <br /> Unit heater Urinal <br /> Beiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINK�LER / SUPPRESSION SYSTEM other: <br /> Numher of Heads Other. <br /> I hereby certify lhat I have read and e:amined this applicatlon and know Ihe same l0 6e irue and correct.All provisions of laws and ordinances goveming <br /> ihis lype of work will be complietl wi�h whelher sp^Ufed herein or not.The granting ol a permit does no�presume lo give authonly lo vio�ate or cancel <br /> ihe provision of any her state local law regula�ing cons�ruction or ihe pertormance of construclion.Tha�I sm aulhori�ed 6y�he owner of this praperty <br /> �o peAorm ihe wor fo�hic�q li ation is made and I comply wilh Ihe Sla�e Contractors Law 18.27 RCW and 296.200 WAC <br /> � W . 6 z9ii <br /> OwnerlAutho zodAgontSrqnature Dae (Revisad2R011) �I� <br />