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� • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITEADDRESS: PROPERTVT N DD / �OD RMIT <br /> E � � <br /> LEGAL(or new conslruclion: S�orl PlaVsu00ivision Lot No._ (atlac�copy ol long legal Cescnplion) <br /> OWNER � � Q PhonelE-mail <br /> Address Cityl51ale2ip <br /> APPUCANT: Owner OwnersAgenl Conlraclor CONractor'sAgent T¢�d01(mv4paeC�abn�rofconsmilmmtt�eownerioOowoAlniMsp�re) <br /> CONTRACTOR � Slate Lic.S �IS7V GI �O Cit Bus. Lic N <br /> nddress - I � PhonNEmail MIY�E@.�R1AtilT/'�"��T �KS, �T� <br /> ENAN BU IN S NAME CONTACT FOR PERMIT <br /> �� PhonelE�mail ���.��P� NlJ (. � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK !J <br /> Ezisting Use of Building HEAT SOURCE: <br /> Proposed Use of Building �ndo Gas Elec�ric_ O�her_ <br /> Building type� _Single Family _Duplex_Townhouse _Multi-Family ,_Conmercial <br /> T pe ol pro'ect _New _Addilion _Remadel � Repair T.I._Si n_Sprink�er_Demolition Change ot Use <br /> DESCRIPTION OF WORK(adolliona�space p�ovi0ed on fhe eack): <br /> �i vc� �xcs��i s r��NE � ���-l-- Nd�1 �-� <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa of ProJect: _New_Addn _Alterallon_Repair Type of Project: _New_Adtln ,_Altention_Repair <br /> Show Number(MJ o!Iixfures Show Number(M)o/Iixtures <br /> A/C-air handling unils 7oilet <br /> Porced air systems BatMub <br /> Gas pipin Lavato (wash basin) <br /> � Waler heater Shower <br /> Gas fireplace Kltchen sink&disposai <br /> Gas range Dishwasher <br /> � Clothes diyer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink servicelbar/mo /etc.) <br /> Heat pum Backflow preventer <br /> Unil hea�er Urinal <br /> Boiler Drinkin Founlain <br /> Refri eration Floordrain <br /> Woodstove Grease Ira <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Num6er of Heads Olher: <br /> I here�y ceNry ihet I�eve reaE end etaminea Inis epplicalbn entl Fnow Ihe seme la Ee Uue and wnect.An prmisions ol laws an:v;Ginancea gaveming�nis type of work wAI be mmpse0 <br /> wA11 xfiel�er specK¢E 1lcrcin or nol.TI1e qranlirlg ol a pelmil Cces not presume toane aN00titY�o vlotale or WMcI IM'prOvisan JI eny oi�Cr slale ar loCal law regula:ing�nslNclron <br /> TTat I am avl�oriteE Ey I�e owner ol t�is properly lo petlam t�e work lor�MiN apPiicalion is ma0e an01 compry wM I�e Sla;e Ca�tratlorc U�•1l.ti RCW anE 2%200A WqC. . / <br /> � � <br /> �i� � A P2r�- 4/ ���t- <br /> Own rlAToriz�gantSipnature D e (Revised3R0U) <br />