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( l <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX�25-257-8857—www.everett�a.org��2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM J <br /> SITEADDRESS: ►ROPERTYTAXR PERM�TR ^ oy13 <br /> •Z �. ,, �G " v <br /> LEGAL for new constnxilon: S�oA PlaUsubtlivislon Lol No._ (attach copy o1 bnp kqal Eesaiptbn) <br /> ONMER S Pi Phone/E-ma�l <br /> Cdress Ciryl51atM21p <br /> CONTRACTOR ,�r l�1 ! ��.. L 61 Lic.k <br /> dtlresf � ^�sL 5� Y� .�--I�� '�I yZ PhonUEmaii <br /> TENANT USINE33 NAME C NTAC FOR P RMIT <br /> .. P�onelE-mefl <br /> BUILDING PERMIT APPLICATION CON7rsncT PRiCE oF woRK , <br /> Existing Use of BuiMinp HEAT SOUR:f: <br /> Proposed Use ot Building Gas Eleqric Ochn <br /> Building rype: �Singb Family _Dupiez_Trnvnhouse _Multi-Family _Commercial <br /> Type of projed: _New _AddRion _Remodel _Repnir_T.�._Sign_Sprinkler_Demolttion_Chr�ge oi Use <br /> Desulption oi Wo1k(eddilional space povided on 1he back): <br /> Have you startad working without a permit7 _YES _NO <br /> MECIIANICAL PERMIT APPLICATION PLUMBIN6 PERMIT APPLICAYION <br /> TypeotProJeel: _New_Addn _Alteretlon_Rep�ir Typ�olProject: _N�w_AAdn _All�ntlon_Rp�ir � <br /> Show NumDer ol flxfuiss SAow NumDer ol flrfuno <br /> /UC—airhandlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash beain <br /> Water heater Shower <br /> Ges 4re lace Kitchen sink 6 dis osal <br /> Gas ran e Dishwesher <br /> Clothes d er ClotMs wasMr <br /> Ran e hood Water heeter <br /> Exhaust fan Sink servicelDarlmo lete. <br /> Heat um 8acktlow reveMer <br /> Unit healer Urinal <br /> Boiler Drinkin Fountafn <br /> ReM eration Floor CrNn <br /> Woodstove Greaae tra <br /> Dudin Roof dreins <br /> Other Mediwl Gas <br /> SPRINKLER/SUPPRESSION SY8TEM other: <br /> Number oi Heads Other: <br /> I hereby certiy ihat I have read end eKaminetl ihis appliralion and kuow the�ame to be tme an0 correct.All pmvision�01 laws anE adinanas povemiip <br /> this type of work wlll tre complied xith whet0er apecified hereln or not.The prenlinp ot a permil dces not presume to give aulhority to videte or cancel <br /> Ihe provision of any other state or laal law regulating conslmclion or the peAormence ol conaWdion.Ti�at I am aut�oiized by tM amet ol lhb pmperry <br /> t/o�pertorm Ihe Mork for which epplication is matle and 1 compry with IM Stete Controdora Law 18.27 RCW an0 298.200 WAC <br /> �/_y �� � / �7�']/� <br /> � VNTerIANhodzad Aqenl S gnatun Dale (ReWsed?/2011) <br />