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PERMIT APPLICATION <br /> BUILDI�VG/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-25'I-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �]� a.S"� Z� <br /> SITEADDRESS: ,� PROPERTYTA%N PE IT• 7 <br /> �� 7Z C� <br /> LEGAL fcr new construction: Short PlaVsuLdivision Lo�No._ (altach copy ol long�eqal tlescriptioi.) <br /> OWNER t5 � Phone/E-mail 7 220' ��3 �+U�S,�5Z�7� <br /> �lZ CitylSlate2ip t�-C�'l� W� ��I �n�t�'• <br /> Atldress - <br /> APPLICAMT�-Owner OwnersAgent _CONraclor GoNractor'sAgent TCnON�mvs�D�roeeier.rrolwmemlrommewnertoEowork�inmeapa:e) <br /> CONTRACTOR L 8 I Lic.# COE Bus.lic.# <br /> Address PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building �`'�'�"���' HEAT SOURCE: <br /> Proposed Use o(8yt�ding �����K�-� Gas_ Eieanc_ Other_ <br /> Building type: l Single Family _Dupl Townhouse _Mulli-Fami�y _Commercial <br /> T pe of pro'ed New Addit�on ��odel _Repair_T.I. Sign_Sprinkler Demoli�ion Chan e of Use <br /> DESCRIPTION OF WORK(adddioial space provitled o�tho back): �. <br /> �no��l �-��z�az w�"� �'. -1.r�`Ct��i��-e c� <br /> gc�c��. i��� ��-��c-r- �.��� �-v�s c��� <br /> ��-�-�,-��� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ot ProJect: _Now,Addn _Alteratlan_Repalr Typo of Projecl: _Now_Addn _Alteration_Fepalr <br /> Show Num6er(p)ol/ixtures Show Number(N)ol lixfurcs <br /> A!C-air handling units ' Toilet <br /> � Forcedair:ystems Bathtub <br /> � Gas piping Lavatory(wash basin} <br /> ! Water healer ; Shower <br /> Gas(ireplace ; Kitchen sink&dis osal <br /> Gas range � Dishwasher <br /> Clothes d er � Clothes washer <br /> Range hood � Water heater <br /> Erhaustfan I Sink(servicelbadmop/etcJ <br /> Heat pump � Backflow preventer <br /> � Unit healer I Urinal <br /> 6oiler I Drinking Fountain <br /> j Rafrigeration I Floor drain <br /> Woodslove � Grease irap <br /> Ducting I Roof drains <br /> Other � A9edical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> � Number of Heads �i Olher: <br /> I here0y cetllly I�at I have reed and exemined ihis a pliwtion and kr.cw Ihe sama lo be Imo,+,rd correct.All Vruvisions ol lan�s and oidmantee goveming ihis type ol work will be compUed <br /> wrth wTether spec�etl hereln or not Tho granti of a ertn�l Eces not presume to glve eutiisnty to violate or canrel Ihe provisron ol any ot�er Goto or Itta�Ifiv rzpulating consWction <br /> Ihai I am aulhodzeG by ihe ow�er ol ihis orop rIY�o pe ortn Ilro wrork for v:h¢h uFFbwtion is maAe anE I compty wnh��e Stale Coniractors Lew 18.27 FCW antl 295 2WA WAC. <br /> ' � //�` ` <br /> C� � V`' <br /> Ownorl Ih izr.d Agent Signaturo Date (Revised&20f2/ <br />