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1 <br /> PERMI�' APPLICATION <br /> BUILDINGIMEGHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., [verett, WA 98201 -425-257-8610— FAX 425-257-8857—wvvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �'� (,� �1� <br /> PROPERN TAX p P�X� � ,O G <br /> /� <br /> SG� ��,�� r � • <br /> LEGAL lor new conslructlon: Shorl PlaVsubdivislan Lot Na._ (e�lach copy of long legal descnption) <br /> OWNER x'( / 4 � / � 'J -/ f� ,,�T�h Phonc/E-mail �'J�S`.�d��sJ�� <br /> Address �� l City/StatelZip /� �'L G�S <br /> CONTRACTOR �s�c'i'/!'��[ /'! � Y/ L&I Lic.# -���7�t� <br /> l . r ' L��.S'�S `�� <br /> Address ' -' i�J/ � � � � Phone/Email — <br /> TENANT BUS�ESS NAME COIJ�ACT FOR P�ftMl�� <br /> �� � �sr.r E� ,a r✓ <br /> � � `yr` Phone/E-r�il r as-a�o-s� J <br /> BUILDI ERMI APPLICA ION coN7RAC7 PRICe oF WORK S-S�C7 cx� <br /> Exisling Use of Building EAT SOURCE: <br /> Proposed Use o(Buildingy;" '''" G`'� � S��N Gas_ Elec�ric_ Other_ <br /> Building type: Single Fan ily _Dup�ex_Town ouse _Mulli-Family�Commercial <br /> Type of proJect: _New _Addition _Remodel _Repalr_T.I._Sign�Sprinkler_Demolition_Change of Use <br /> DesCrip�ion of Wofk(eddilional space provided on fhe back): <br /> �<�l� /9 ,fr�v -�'i���v s <br /> Have you started working without a permit7 ,�YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypooiProJoct: _Now_Addn _Alloratlon_Ropair TypootProJect: _Now_Addn _Alloration_Repalr <br /> Show Number(tt)o/flxtures Show Number(N1 0(Ilxfures <br /> A/C-air handling unils _ Toilet <br /> Forced air systems _ Bathlub <br /> Gas piping _ L-avato (wash basin) <br /> Waterheater _ Shower <br /> Gas fireplace _ Kitchen sink&disposal <br /> Gas range _ Dishwasher <br /> Clothes dryer _ I Clothes washer <br />�"� — Water healer <br /> Range hood — <br /> Exhaust fan _ Sink(service/bar/mop/etc.) <br /> Heat pump _ Backflow prevenler <br /> Unit heater _ Urinal <br /> Boiler _ Drinking Fountain <br /> Refrigeralion _ Floordrein <br /> Woodstove _ Grease lrap <br /> Ductina Roof drains <br /> Other _ Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM _ Other <br /> Number of Heads — <br /> I hereby cenify Ihal I have read and ezamined this applicalion and know Ihe same Io be Irue and correcl.All provisions of laws and ordinances gaveming <br /> Ihis lype of orx will be complied wilh whether specified herein or not.Tho granting of a permit does nat presume lo give aulhority to violate or cancel <br /> the provis ot any er slale or local law regulating conslruciion or the pedormance ol construclion.Thal I am aulhonzed by the owner of Inis propedy <br /> to peAor he wo t w ich applicalion is made and I comply with the Slate Contraclors Law 1027 RCW and 296200 WAC <br /> � ��� / �( ` (Revisetl72/1070J <br /> Ow Authorizad Agont Signaturo Date <br />