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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLERIDEMOLIT ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereri, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERN TAX p PERMIT N <br /> r �v� '� � U <br /> LEGAL for new consiruction- Short PlaUsubdivision Lol No_ (atlaU copy of long legal descnption) <br /> OWNER D n �\� PnonelE-mau � ' �1u� ' �l� T <br /> ntltlress q 5 City/Sw�e2ip `� �l —\ <br /> APPLICANT: Ovmer Owner'sAgent� Contractor ContractorsAgent Tenant�mm�oro„ae.anero�mnxm�mmu+eo�«ne�ioaown�mnemace� <br /> CONTRACTOR � �^ t� � L 8 I Lic# �W � ' COE Bus.Lia# <br /> Address �� _ � �� � PhoneJEmail ��5 � g �^!� <br /> TENANT BU INE S NAME N ACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK a CI � 5 • lc D <br /> Ezisling Use of Building HEAT SOURCE: <br /> Pmposed Use of Bwldmg Gas_ eiectnc_ Other_ <br /> Building type�' Single Famlly _Duplex_Townhouse _Mulli-Family _Commercial <br /> T of roect: New Addilion Remodel� Re air T.I. Si n S nnkler Demolilion Chan e ofUse <br /> DESCRIPTION OF WORK(addi�iona�space pmvided on the back): <br /> i�e- ��-f — ��c�I�tcc' nnct;�zr��(. � <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofPrqect: _New_Atldn _Alteration_Repair TypeolProject: _New_Addn _Alteration_Repair <br /> Show Number(p)ol fixtures Show Number(#)ol�ih�res <br /> A/C—airhandlin units Toilel <br /> Forced air s stems BathWb <br /> Gas pipin Lavato (wash basin) <br /> Waler heater Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water healer <br /> Exhaust tan Sink�servicelbarlmo letc. <br /> Heat pump Backflow prevenler <br /> Unit heater Unnal <br /> Boiler Drinkin Fountain <br /> ReFri eration Floor drain <br /> Woodslove Grease tre <br /> Ductin Roof drains <br /> Olher ' Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM II Other. <br /> Number of Heads � Other <br /> I neieCy cerlM�al I have read ana eaamineU Nis aDP����°n nnd know I�e same lo Ge true anG mrted.A1 provisions ol laws and aNinances goveming this lypa olwotic wdl Ee compYed <br /> ��in wlwlher 6peafie0 hemin or nol.The granling ol a pertn�l Eocs noI pmwmo Io give auNomy lo vrolalc or wncel t�e D��ision ol any oNer stato or loral law reguWtmg mnshudion <br /> in:n I am auMon2oC Uy Rle awner o1 Nis DroVerty lo DeNortn��e woM lor whirli aVDlic.itron is maCe anU I compy���Ihe Slate Coniraaors Ww I B IT RCW an0 296.YOOA WAC. <br /> 5��, �K (�� � �1,��,� � - l3 <br /> OwnerlAuthorized Agent Signature Date (Revisetl fi20f2) <br />