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PERMIT APPLICATION <br /> BUiLDINGIMECHANICALIPLUNiBING/SIGN/SPRINKLER/DEMOLITION <br /> C17Y OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 - 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PFOPER7Y TA%N PERMIT# <br /> SITE ADDRE55: � � <br /> �, I c4 � —' r _ C�O�13 03� � C�0 �GO `' � <br /> LEGAL lor new constructinn: Short PlaVsubdrvision C(f� i�tv L 3�(e3`i(�oi No.� (attach copy ol long legal descripUo�) <br /> OWNER � _(,f L ��i Phone/E�mail '-- Q � -1 1 z. � � <br /> Address �f - City/S�a�e/Zip 2 �� Qh-y�-S Ri. <br /> CONTRACTOR �� �J Loti'����C--1 L&I Lic.# � I�;GC:)1� C. r 9 Z <br /> n <br /> Atldmss 1 j� i J L�(� l Phone�Email� ZS- )�-`t � N <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �lu. ,v�ti�,s <br /> Phone mail - u0 GL� 2uG..�/U hN1i� �� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Buiiding 7.0�� �'�i ti��� K-�"^'-- _ HEAT SOURCE: <br /> Proposed Use of Building Gas__ . Electric_ Olher__ <br /> Puilding tyoe: �Single Family _Duplex_Townhouse _Mul�i-Family _Commercial <br /> Type of projecC _New _Addilion _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(a[Itldional space provided on Ihe back): <br /> � ,U�.K 1?Y.,C�L �U��� i ,�S\ul l C�L�5�i ��17 C�.c�nSlz.11 �l,w, c�.� <br /> �J <br /> Havc you started working without a permil7 _YFS �NO <br /> MECHANICAL PERMIT APPLICATIQN PLUMBING PERMIT APPLICATION <br /> Type of ProJecL• _New_Addn _Allerallon_ftupair Type ot ProJecL• _Naw_Addn _Allaraliort_Rapalr <br /> Show Number(N)ol Iixfures Show Numbcr(q)o/Oxfures <br /> A/C-air hantlling units I Toilet <br /> Forced air systems � BathWb <br /> Gas piping � Lavatory(wash basin) <br /> Water healer Shower <br /> Gas(ireplace I Kilchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer � Clothes washer <br /> Range hood � Water heater <br /> Exhausi lan � Sink(servicelbar/mop/etc.) <br /> � � Hcat pump I 6ackflow preventer <br /> � Unit hea�er Urinal <br /> � � 6oiler Drinking Fountain <br /> I � � Refriger2tion Floor drain <br /> ,I - Wuodstove � Greasetrap <br /> DucUng � Roof drains <br /> �I Other Medical Gas <br /> SPRINKLER I SUPPRESSION Sl'STEM I other: <br /> � Number of Heads Other: <br /> I here�y cetlily Ihat I have read and examined Ihis application and knmv Ihe same lo be We and correct.All pmvisions of laws and ordinances�oveming <br /> this type of work v+ill be mrsptied wi0i whelher specifed herein or not.Tho grenling ol a permit does nat presume to give authorily to violate or cancel <br /> Ihe provision ol any olher state or local law regulatin�constmction or the pedonnance oi consimclion.That I am authorized by the owner of this pmFerty <br /> to pedorm Ihe�mr�r w�lich-0ppilCatlonis+�ade and I comply with the State Conlradors Law 1927 RCW and 29620D WAC <br /> �/- -�— � J �/ .�J // <br /> OwneRlCuthodzed Apent Slgnaturo a:e (Revised 2R017J <br />