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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., EvereH, WA 98201 -425-257-8810- FAX 425-257-8857-www.everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 517E ADDRESS: ,.Z I �� �iGT ���� P� EpO A n I OOZOO �OO MIT �^ /�/� <br /> �vl L !� ' _w <br /> LEGAL br new conslmc6on: Short PlaVsubtl�vision LOI No._ (atiacA copy ol long lega�description) <br /> OWNER 1/tCTOR( /f �.C/t�.L Phone�Eman �{2S� G. Z-' � fwE /V. �t,i <br /> Atltlress `T� � lTC�W� ��..a City/5late/Zip (��G/C�( , vy Q Q <br /> CONTRACTOR •—` �y L,f L&t Lic:#- � - --�" - �- <br /> Address PhonelEmail <br /> TENANT 6USINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORf: <br /> Existing Use of Builtling R�s,.f.D�/l�T/14L HEAT SOURCE�. <br /> Proposed Use of Building V�'i����sll n ���L(.2�- Gas_ Eieclnc ✓ Other __ <br /> 8miding type�. ✓Smgle Famiiy _Duplex_Tow�nhous�tultl-Famiiy _Commercial <br /> Type of pro�ect _New _Addilion _Remodel _Repair_T.L_Sign_Sprinkler�Demohtion_Change of Use <br /> DescriptionofWork(acd�rronaispaceproviaedonNeeack): pfS�ONN�C.Z' L(r( (,.lj'!£S P�O�� ���� <br /> r�n �rt� u-St. ►�� � .�Opwez �bec„s To �-ccwsr2uer- BGcltD�n�S � <br /> .a,.9p l�ev►to�� fR0•,1 s�t� vi,+ �wkp�Ruc,� o2.�t�2uat� rR�t�c�.�,. pEs�,o <br /> Have you started working without a permit9 _YES _NO "�'0 �,�' �P(��]� (3 /�� [5 2� �2 � � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATiON <br /> Typo of Pro�oct: _New_Atltln _Alteratlon_Repair Typo of ProJoct: _New_Addn _Altoration_Repalr <br /> Show Numbcr(NJ ol hxNres Show NumEer(M�o!liafures <br /> A/C–au handhng uniis Todet <br /> Forc_d air syslems t3alhWb <br /> Gas piping Lavatory(wash Uasin) <br /> Water heater Shower <br /> Gas lreplace Kilchen sink&disposal <br /> Gas ren e Dishwashcr <br /> Clolhes dryer Cbthes washer <br /> Range hootl Water Yeater <br /> Exhaust lan Sink(scrvicelbar,'mop/etc.) <br /> Heat pump Oackfiow preventer <br /> Unit healer Unnal <br /> �oder � Urinkmq Fountain <br /> Re(rigeration Floo�diain <br /> Woodslove Grease Irap <br /> Ducting Roof drains <br /> Other Medmal Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> NumberofHeads Other: <br /> I hereby cetlify Ihat I have read and e.amined ihis appllcalion and know the same to be Irue and correcl All pravisionsol laws and ordinances goveming <br /> t�is lype ol work will he complied with whelher specdietl Oerein or noL The granling ol a permit tloes not piesume to give aulhority to violate or cancel <br /> Ihe vi�ion ol any oI�M 5tate or local law regulaling consimction or Ihe pertormance of Con5lruCiiOn.Thal I am authonzed by Ihe owner ol lhis properly <br /> t e or i U �ta1i n is made antl I comply wi�h Ihe Slale Conlractors Law 1 B 27 RCVJ antl 296 200 WFC <br /> �AN.11 ?.C�12 �(13 2vd n.e•ronfnM�n' <br /> OwnedAutAorized Age gnaturo aie t��'k (Revisetl7?011i <br /> �,�, s.r. �� <br /> � <br />