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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-Ba10— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �. .� <br /> SITEAD ESS: PROPERTYTA%p PE IT+t _OD <br /> l �o l 2 '� <br /> LEGAL for new construclion: Short PlaVsu6division Lo�No._ (a�tach copy of long legal description) <br /> OWNER F P�21s PhonelE-maii �}ZS=891 -IGv} d id. e <br /> Address�0 �� �32g-S Ci�y�staterzip (�-11I.F-G{�•EK .a 98o�Z <br /> CONTRACTOR SlS � , I�c • CO L&I Lic. # SU rj 2�`,Lp � .�C <br /> p '.1 �F2S-7�+2 -0 0 <br /> Address (p0 - � � � L- W • �.. 1!J PhonelEmail a M N. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT D�� �{S' <br /> PhonelE-mail Z�'�9 � ' l `�T" Q'aJld . aeI G�7WL � � . <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �'^ <br /> Existing Use of Building ��N�x HEAT SOURCE. <br /> Proposed Use ot Building ��S �.D�N GE Gas� Electric_ Other_ <br /> Building type: �,Single Family _Dupiex_Townhouse _Multi•Family _Commercial <br /> Type of project: _New _,Addition �[Remodel _Repair_T.I._Sign_Sprinkler_Demolition,_Change of Use <br /> DeScriptionofWork�additionalspaceprovidodonlheback): R �7�UFf�-��,Jr 5.7,�((p � Syv9�'Au�. Avoi��� <br /> F� <br /> �v Cd�F—fL <br /> Have you staAed working without a permlt? _VES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ot ProJoct: _Now_Addn�Alteretlon_Repalr Type of ProJacl: _New_Addn _Alteralion_Repair <br /> Show Numbcr(M1 0l lixturos Show Number(MJ o/flxfures <br /> A/C-air handling units Toilet <br /> Forced air systems Balhtub <br /> Gas piping Lavato (wash basin) <br /> � Water heater Shower <br /> Gas freplace Kitchen sink&disposal <br /> Gasrange Dishwasher <br /> Clothes dryer Clo�hes washer <br /> Range hood Water heater <br /> Exhaust fan Sir�k(service/barinopletc.) <br /> Heal pump BackBow preventer <br /> Unit healer Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floordrain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads Other. <br /> I hereby certily Ihat I have read and examined this applicalion and know lho same to 6e lrue and correct.All provisions of laws an.1 ordinances governing <br /> Ihis lype of work will be complied with whetner specifed herein or no�.Tha granling of a permil does no�presume lo give authonly lo violate or wncel <br /> Ihe provision of any other slate or local law regulaling conslruction or the pedormance of constr�ction.Tha�I am authorized hy Ihr;owner o1�his propehy <br /> to pe �e work�or wlych a�plicalion is made and 1 comply wilh Ihe State CoNractors Law 1827 RCW and 296.200 WAC <br /> � Y <br /> � ' ' � '1 33� � <br /> � L <br /> OwnodAuiholl d Agant Signahre D le (Revised2l1017) <br />