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PERN{IT APPLICATION <br /> BUILDING/MECHANICAL/PLUIVIBING/SIGN/SPFtINKLER/DEII�lOL1710N <br /> CITY OF EVERETT PERMIT SERVICE.�'i <br /> 320D Cedar SL, Everelt,WA 98201 -425-257-8810—FAX 425-257-8357—vrvdvd.everettwa.org <br /> APPLICATIONS ARE?CCcPTED FROM 8 AM TO 4 PM {�ERMI7 H <br /> PROPERNTA%p /�rI 'n �._�J�� <br /> SITE ADDRESS: ,� � <br /> �O/� iLk G/'� ✓� <br /> LEGALforneweonslmction: ShodPlaVsubtlivision - <br /> Lot No._ (atlach copy ol lung�egal tlescription) <br /> � L PhonclE-mail �i� "-3y�- 36 <br /> OWNER LYn�7( �1 r . I� f <br /> AdtlmsS �,:FID. � c v c�iv�s�ateiz�a .✓trt /�4. r!?-D3 <br /> L&I Lic.# /� . 5 � <br /> CONTRACTCR � �liar � i� �*`� � � � � " � / .{-��-f <br /> OG�� y +- ✓ � :i�� �'f0�) W� P�one![mail���5-�OS "v`"'-C'v� <br /> Atldre,s CONTACT FOR PERMIT <br /> TENANT BUSINESS NAME <br /> Pno�eie�mau JtF �� ���� � �i�S-�S'Y b�`ie S <br /> BUILDING PERMIT APPLICATION <br /> CONTRACT PRICE OF WORK ✓I(717�( <br /> ��(r HEATSOURCE: <br /> Ea�;�ing Use of Buliding �r <br /> �Ts_ Electric� Other_ <br /> PrcposedUseofBuilding S4•t< <br /> 6uiidingtype: S SingleFamily _,Ouplex_Tovmhouse _Muiti-Famiry ,_Commercial <br /> Ty,eofpmject: _New _Addition _Remodel X Repair_T.I.,_Sign_Sprinkler_�emolition_Change ofUse <br /> Desviplion of Wofk(adJi(ional space pmvided on Ihe backJ: <br /> lQrMcvt d1� I�ul<t,,S wo.�o- N-�u'�va�d rtFJ�4c. <br /> u��� nrov <br /> Have you started working wilhoul a permil7 _YES �NO <br /> MECFiANICAL PERMIT APPLICATION <br /> PLUMBING PEkMI'T APPLICATION <br /> TypeofProjecU ,_Ncw_Addn ,_Altemlion,)L.Rr.pair TYPeoiProjecL _ New_Addn ._Alleration_Repalr <br /> Show Num6cr(HI ol�.Kures <br /> ShowNumtcr(4)ol/ixfures � Toilet <br /> � A/C--airhandlingunils � BathWb <br /> � Porced zir syslems Lavalory(�•vash basiN <br /> � Gas pipinq Shovrer <br /> � � Waler heater � Kitchen sink 8 disposal <br /> � Gas tireplace � p;shwasher <br /> Gas ran e � Cbthes�vasher <br /> Clothes dryer � Water heater <br /> � ftange hood � Sink(servicelharlmop/elc.) <br /> ', � Exhaust fan �"— p��Mlow preventer <br /> � Heal pump � Urinal <br /> � Unit heater Drinking Fountain <br /> I Boiler � Floordrain <br /> � Refrigeration � Grease trap <br /> � Woodslove � Roof drains <br /> i i Ducting — I Medical Gas <br /> Olher I <br /> SFRIFIKLER ! SUPPRESSION SYSTEM <br /> Other. <br /> j Olher: <br /> � Num6=r of Head.; <br /> I hcreby cetlly�hat I Yaw read and examir.ed N;s application and knew tho samo W he We and correcl.A11 provisions ol laws and erEinances govemin3 <br /> tl��.is type ol work v+ill be mmp�ietl wilh whether specified hcrcin or not.Tho grantlng ol a peimit does not presume to give authonty to vlolate or wncel <br /> V��e provision ol any other s�ato or local law regulating wnsiruclion or the performanco ot consiruclion.That I am authoiized by tho oxner ol ihis properry <br /> Io pedorm Iho work(or whieh�lieal�y�s m�j and I eomply wilh Iho Stata Conlraetors Law 1827 RCW�na 298.200 WAC <br /> � ��.!l�'�'�_r.,-� � �S � Y�- (Revised 712071) <br /> Owni�'(wlbArized Agent Signaturc <br /> , Da!e <br /> % <br />