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r- ERMIT APPLICATIOI� <br /> BUILDQNG/MECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVcRETT PERMIT SERVICES <br /> 3200 Cedar Sl., Everett, WA 98201 -425-257-881 U—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PR9PERtY TA%q PERMIT# <br /> ( ' � �� � �'�Ci. _ �CJC��� <br /> LEGAL for new constmction: otl PlaVsubdivision Lol No._ (altach copy ul long legal description) <br /> OWNER �--l;i��l��'�'(�C' � � �C��� PhonelE-mail �(� �(– . <br /> 1 City/Sta�e/Zip � G;� T <br /> Address I - 1 � - � <br /> CONTRACTOR L 8 I Lic.# <br /> Atldress Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-�,ail <br /> BUILDWGPERMITAPPLICATION CONTRACTPRICEOFWORK L -(` jv <br /> Existiny Use of 6uilding <br /> HEATSOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ot project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> D�scripliori e!Work(addifionol space provided on fhe back): <br /> '� � ; � � ��l � �1L�� � �'�t- ,,)I�'�l, � �� �c;`� � ,�,)� f' �� �v 1����i, <br /> 1 f _._ C��c`! i , _ �� a . <br /> Have you started wdrkin9 withoul a permit7 _,YES _NO <br /> MECHh�11CAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoolProJoct: _Now_Addn _Altaration_Repalr TypoolProJect: _Now_Addn _Altnration_Ropair <br /> Show Numbcr(N)ol IixNres Show Numbw(#)of/ixtures <br /> � !VC–air handli�9 units _ Toilet <br /> Forced air systems _ � �atMub <br /> Gas piping _ I Lavalory(wash basin) <br /> I Waler healer __ � Shower <br /> Gas(ireplace _ � Kilchen sink 8 disposal <br /> Gas range _ Dishv.•asher <br /> Clothes dryer _ I Clothes washer <br /> Range hood _ Water heater <br /> Exhausllan _ Sink(service/badmopletc.) <br /> Fleat pump _ Back(low preventer <br /> Unit heater _ Urinal <br /> Boiler _ I Diinking Fwntain <br /> I� Relrigeralion _ Floor drain <br /> Woodstove _ I Greasetrap <br /> � Ductinn Roof drains <br /> Olher _ � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM , Olher <br /> Nun�6cr ol Heods — � ---- <br /> . �.ahy ceitify Ihat I have iaad and examined Ihis application and know Ihe same lo be Irue and correcl.All provis'ons of laws and ordinences goveming <br /> I,����:;ty pe of work wiil 6e complied wilh whether specified herein or not.The graNing ol a permit does not piesume fo 8��e authoGty to violale or cancel <br /> u,c;�aovision ol any olher state or local law regulaling conslmction or iho pedonnanco 01 r,onstruclion.Thal I am authorizetl by the owner ol this proDeAy <br /> �c perform Ihe�vork lor which ap ication is mada antl I comply with tho Slale Coniractors L.aw 1827 RCW and 2J6.20J WAC <br /> i <br /> � � � , � �� � � ! � � l <br /> ��.. �. � �'_ ' �Remsed 72R010J <br /> Ow�milAuthorlmd Agent Sign�ture� � L`ate <br />