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� <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETf PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—wvnveverettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TU 4 PM �� `� � I, <br /> SITE ADDR SS: <br /> PROPERTYTA%1t PERM t <br /> I� Ip 'E' Gk <br /> LEGAL for new conslruction: Short Plal/subdivision Lot No._ (allach copy ol long legal descrip�ian) <br /> I Phone;E-mail S-`�7 -�07� b�rdPrtJ� icSV �c C �w. <br /> OWNER . " h 1--- �nC�� 1^ p.� �� <br /> Address �-� (� '�� /'YC�\ `L Ciry/Slate/Zip ��G�G.� ��l- �dd � <br /> CONTRACTOR n I -<a�n L 8 I Lic.# h t� �� / <br /> Address PhonelEmail �{� �a —� �" <br /> I ✓DoCIWa� CONTACTFORPERMIT <br /> TENANT BUSINESS N:,ME <br /> �1�il- PhonelE•mail <br /> (N /� <br /> BUILDING PERMIT APPLICATION coN7ttAc7 Pa.1Ce oF WORK <br /> HEAT SOURCE: <br /> Exisling Use of BuilGing <br /> Gas_ Electric_ Olher_ <br /> Proposed Use of Building_ <br /> Buildingtype: SingleFamily _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project_New _Addition _Remodel _Repair_T.I._Sign_Sp•inkler_Demolition_Change ot Uss <br /> Descriplion of Work(r.dditional space provided on tho back): I <br /> Have you staRed working wilhout a permit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PEY2MIT APPLICATION <br /> TypoofProJoct: _Now_Addn _Alforation_Ropalr TypeofProJecl: _Now_Addn _,AlteraUon_Repair <br /> Show Number(N)olOxtures Show Num4er(q)o/llxfurcs <br /> A/C-airhandlingunils � Toile!__ <br /> Forced air s slems Bs�htuS <br /> Gas piping Lavato (wash basin) <br /> Water healer _ <br /> Shawer <br /> Gas fireplace Ki�chen sink&disposal <br /> Dishwasher <br /> Gas range Cbthes washer <br /> � 1 Clothes dryer <br /> Range hood Waler heater <br /> Exhausl fan Sink(service/badmop/elc.) <br /> Backtlow preventer <br /> Hea�pump Urinal _ <br /> Unit healer <br /> 6oiler Drinking Fountain <br /> Floor drain <br /> Refrigeretion - Grease trap <br /> Woodstove <br /> Ducting Roof dreias <br /> Medical Gas <br /> Olher <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> NumberofHeads � Other. <br /> I hereby cehify thal I have read and examined Ihis application and know Ihe same to be lrue and cartecl.All provisions of laws and ordinances goveming <br /> this type o1 work will be co:nplietl vrih whelher spedfied her_in or noL The granling of a permil Aoes nol F:esume lo give aulhority to violale or cancel <br /> Iho provision of any other sl:�te or loca�!aw regulaling tonslruction or Ihe pertormanca ol conslruclion.That I am oulhorized by the owner of this property <br /> �o pedorm�1 Ihe work for whi h appliv.aon is made and I comply wi;h Ihe Slate Conlraclors Lew 1827 RCW and 29u200 WAC <br /> �' l �� �� `l /�l�ll� (RevisedY1011) <br /> pwnorlAu:hodzad Agont Signaturo Dato <br />