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�. <br /> t- E�RMIT APPLICATIOIv <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLE�R/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 9d201 -425-257-8810— FAX 425-257-8857—w�^nv.evere?twa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROPEHTYTAXtt �RM//�I _ :17 � <br /> n/ (/ 9 <br /> y i '�� ^ <br /> LEGAL lor new conslmction: Sho(PlaVsubdivision_ _ Lot No._ (attach copy of long legal descriplion) <br /> OWNER r��� �� AC�- Phone/E-ma.' `�p.5 ya� .S.i� .� <br /> Address i�� - City/Stale2ip ��u���,_j <br /> CONTRACTOR � S n. / L&I Lic.# <br /> ' Phone/Ema�l <br /> nddress <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT � <br /> 1>> so� �-�� C�.� <br /> PhonelE-mail �-� • <br /> BLlILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> 5��C HHAT SOURCE: <br /> [xlsting Use af Building <br /> Gas Electric�Other_ <br /> Proposed Use of Building — <br /> Buildiny type: �Single Family _Duplex_Townhouse _Multi-Famity _Coinmercial <br /> Type of project: ,_.New _Hddition _Remodel _Repair_T.I._Sign,_Sprinklcr_Demolitton_Change of Use <br /> Description of Work(addif�onal;pace providetl on Iho back): <br /> 7 � <br /> ��P� � ��4r�otC,i= ���� �U '�Q <br /> / <br /> Have y'ou started working wilhout a permit9 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJecl: _New_Addn _Alleration_Itapalr Typo of Projeel: _7ow_Addn _Alteration_Ropair <br /> Show Num6er(N1 0/lixtwes Shaw Number(#)o/lixmres <br /> � A/C-air handling unds _ Toilel <br /> � Forced air syslems _ � 6athtub <br /> � Gas piping _ Lavatory(wash basin) <br /> Walerheater _ � Shower <br /> � Gas fireplace _ I Kitchen sink&disposal <br /> — �ishwasher <br /> _ � Gas range -- Clothes washer <br /> � Clothes dryer — Waler heater <br /> — _ Range hood '— Sink(service/badmop/eicJ <br /> — � Exh.aust fan — <br /> � BackOow preventer <br /> - � � HPa!pump -- Urina� <br /> -- � Unit heater — <br /> � Boiler __ I Drinking Fountain <br /> � — Floor drain <br /> _ Re(rigeration — Grease trap <br /> Woodstove — <br /> - j �ucting ._ Roof drains <br /> � Other__— _ � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM _ O�her <br /> Numher of Heads — <br /> i <br /> I hereby cedify thal I have mad antl examined Ihis application ar.d know the same to be Iruo and correct.All provisions of Imvs and ordinances govern��np <br /> Ihis typo ol work�vill6e complied wilh�vheUier specifed herein or noL The granling of a permil does nol presume to give aulhonty lo violale or cancel <br /> the pwvision of any other state o�local la�v regulaling construclion or the pertormance of censWclion.Thal I am authoiized by Ihn ov;ner of Ihis preperty <br /> lo pedorm ihe wark for which applicalion is made and I comply wilh Ihe Stale ConUactors Law 1827 RCW and 2°G20��1!nC <br /> �';' -� i�l�� �l _ <br /> , �. «d ,�.:�,o <br /> OwncrlAiithorized A9en1 Siynature � <br /> o,�� ;,:�._ , <br />