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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everellwa.org <br /> APPLICATIONS ARE ACCEPTED FROM!AM TO d PM �I � � <br /> SITE ADDRE8S: I 1 e�G 1,F. PROPEIIP/TAx M P �T�_� <br /> � •, <br /> LEOAL fw new consWdbn: Shoh fl�V�uDdlvliion Lot No._ (�n��PY o(laq Nqd desaqtbn) <br /> OWNER rhonelE-man <br /> �au <br /> � ciry�su�a2W <br /> CONTRACTOR � L 8 I Lic.�k <br /> nte � A S� M� W 9� hoLnuEm�Y � 2'1 ,�`Z — <br /> � rn • F�v1e �'�$ <br /> PhonelE-m�A <br /> dU1�DIN0 PERM ArPLI ATION CONTRACT PRICE OF WORK .��n��� <br /> Exiating Use ot Buildfng HEAT SOURCE: <br /> Proposed Use ot Building Ges ENctAc OtMr <br /> Building type: t8ingle Family _Duplex_Tovmhouse _Mulli•Family _Commerdel <br /> Type of project: �.New _Addition _Remodel _Repair,_T.I._Sign_Sprinkler_Demolition_Chenge of Use <br /> Description of Work(additionel speca piovided on the beek): <br /> Have you shrted workinp without�permit7 _YES ,_NO <br /> MECMANI�AL PERMIT APPLICATION PLUMBINd PlRMIT APPLICATION <br /> Typ�ofP�oJ�cL _Nwv_Adtln _.AlbnHon_R�pHr lyp�olProJwt _!Nw_Addn �Ib�Nion_R�pdr <br /> Show NumMr oI flxtuns SAow NumWr o/8xluna <br /> AIC—air handlin units Toilet <br /> Forced air s slems Bathtub <br /> Gea i i Levato wesh besin <br /> Water heeter Shower <br /> Gea fire tece Kitchen sink 8 dis aal <br /> Gas ran e Diahwaaher <br /> Clothes d er Clothes wesher <br /> Ran e hood G f Weter heater <br /> Exhaual fan � Sink aervicelbar/m /etc. <br /> Heat um 86c4flOW roventer <br /> Unit heater Urinel <br /> Boiler Drinkin Fountain <br /> Refi eration Floor drein <br /> Woodstova Greaae tre <br /> Ductin Roof drei�s <br /> Other Medial Gaa <br /> 8PRINKLER I SUPPRESSION sY8TEM aher <br /> Number of Heads � OtMr. <br /> I hereby cehfy thel I have reed end ezamined thie applicatlon end know tM seme to be true en0 cormd.All provhbns o(I�wt�nd ordln�nca�powminp <br /> this type of work will be complied with whether speGfied hereio or not.The 9nntinp of�permlt doe�nol preaums to pivs auttwAly to vbl�b or ancN <br /> the provision ol eny other slate or loul lew reguletinp conslrucllon or tM peMoim�nce ot construdbn.Thet I�m authaized by IM ovmer o11Ma propeM <br /> to pertortn the work brwhich epplicetlon is mede and I comptywith tM Sute Conlndon l�w 78.27 RCW aM 298.200 WAC <br /> . � �a� �-�i 'r <br /> OwmMAuthoNz�dAp n Sipn�tun Date (Mvlsed7l�Of1J � <br />