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PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8B10-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � _ a S—I' <br /> t <br /> � – <br /> LEOAL lar new construction: Short PlaUsubdivision Lot No._ (attach copy ol lonp leflel dosufption) <br /> OWNER �px Phone/E-mali �ZS ' ZS — <br /> Add�ess 3 CitylStatMZip ��C rT 6. <br /> CONTRACTOR T L 61 Lic.# � Z l WI <br /> Address ^ 0 ,y� Phone/Email Z,S'� - �/p,S'- 78�95 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT/1_� y ��xAw�JEI� <br /> Ct' <br /> Phone/E•maii ZS3' � ' <br /> BUILDING PERMIT APPLICATION coNTRACT PRiCE oF WORK � ODO,GG <br /> Existing Use ci Building �� HEAT SOURCE: <br /> Proposed Use of Building Gas Electr�c Olher <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of proJect: _New _Addltion _Remodel _Repalr_T.1._Sign_Sprinkler_Demolltion_Chaage ot Use <br /> Descripli0n ot Work(eddifionel spacepmvidedon the back): <br /> �i.LOCA7'LUftl OF Gh:% MrT�' � <br /> Have you started worNing without a permft7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typ�ot?roJect: _New_Addn _Altoratlon,_,Repalr TypeolProJecl: _New_Addn �Altetallon_Rap�l� <br /> Show Numbcr(M)o(flxfures Show Number(N)o/flxfures <br /> A/C–air handlin units Toile� <br /> Forced air s stems Balhlub <br /> _ �/ � Gas piping Lavato (wash basin <br /> -��----r Waler heater � Shower <br /> Gas fireplaco Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes dryer Cbthes washer <br /> Ran e hood Waler heater <br /> [xhausl fan Sink(servicelbarlmop/etc.) <br /> Neat ump Backflow reventer <br /> Unil heater Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeralion Floor drain <br /> V�'oodslove � Grease�ra <br /> Uuclin Roof drains <br /> Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM _ Other_ <br /> Number of lieads <br /> I hereby certily Ihat I have read and examineo Ihis application and know�he same lo be Wo antl carreci.Ail provisions ol laws and ordinances goveminy <br /> this type of work will be cmnplied wilh a•hMher specifed herein or not.The yranting ot a pemiil does not presume to give authority to viola�e or cancel <br /> Ihe provision of any other stale or local law regulaling conslruction or Ihe periormance ol conslruction.That I am aulhorized 6y Ihe owner of Ihis property <br /> to ped�rk for whi h a lication is e and�comply with the Sla�nlractors Law 1827 RCW and 296.200 WAC <br /> � -�,� /� - �� <br /> OwnodAy�odzed AgenFSigna�uro Date (Revised 122070) <br />