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. - � �ERMIT APPLICATIG�� <br /> BUILDINGIMECHANICAUPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVEREIT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM I AM TO 1 PM 9 �O7'—(/ <br /> SITE ADDRESS: VROPEIITY TAIf 11 PERMIT <br /> 1 I�F�rJE FIE�O WhY E.vcRETi WA 4,.��1 ' <br /> IEGAL for new conswction: Shon PlaVaubdivlaion�53kSTc E �ir9Gc3�_Lot No._� (anach copy ol bnp lepal descnplion) <br /> OWNER �� ,'�cS NuJ i_t_C PhonelE-mai� �4ZSJ 33� -552� <br /> neeress {�� b'�Y 14�ty City/Stete/ZiP N1�� C.i.�K Ii.JA `1:��� <br /> CONTRACTOR C.oR �rts-t � �-IcMi.S N�J U.0 LdlLic.lt C�%RNtHni9`Il LA <br /> C4i5 >3Y'S:Oi: <br /> Address PU Q� ���y2y ���u �'EEk �.f�t 94'UtZ PhonelEmail r��tr�c:�N•,Sti�+=�+aM<S.uf <br /> TENANTBUSINESSNAME CONTACTFORPERMIT �,,,q� �MP��-R <br /> vhonerE-maii ��-i25)33ti-5555 M�ec,.RH�nnr_H�r�,cS.uS <br /> BUILDINGPERMITAPPIICATION CONTRACTPRICEOFWORK_ _ <br /> Ezisting Use ol Building_�____ HEAT SOURCE: <br /> Proposed Use of Building__,__ _ Gas_X_ EieMric____ Other____ <br /> Building type: 1l Single Family __ Duplez_Townhouse _Multi•Family _Commercial <br /> Type of project: _�New ___A�'�ition __Remodel _Repair__T.I._Sign_Sprinkler__Demolition_Change of Use <br /> Desc�iplion of W ork(additional pace provided on fhe backJ: <br /> 6ASic {� y � Z \ PU� �'R9S 3� <br /> Have you atarted working without a permit7 __YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: �New_Addn __ AltanOon_Rapalr Type ol ProJ�d: �N�w__Addn _Allvalion__Repair <br /> Show Number KJ ol flxtuni Show NumMr t o/flrtunt <br /> fUC-airhandlin units 3 Toilet <br /> Forced air; slems 2 Balhtub <br /> Gas i in Lavato wash basin <br /> W ater heater Showar <br /> Gas fre lace 1 Kitchen sink d dis sai <br /> Gas ran e Dishwasher <br /> Clothes d er 1 Clothes washer <br /> Ran e hood Water healer <br /> y Ezhaust tan Sink servicelbarlmo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinki Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin Rool dreins <br /> Other__________ Medical Gas <br /> SPRlNKLER / SUPPRESSION SYSTEM other: <br /> � Number of Heads Other: <br /> I hereby certily Ihat i have read and examined lhis application and know the same to be lrue and wrrect.All provisiona ol laws end adinances govemirp <br /> this type ol vrork will 6r complied wilh whether specified herein or rrol.The granting W e permit dces rwl presume to give aulhority to vio�ate or cancel <br /> Ihe provision ol any other state or local law regulating construclion or Ihe peAormance ol cons�rudion.That I am aulhorized by the owner ol this property' / <br /> to peAorm the wvrk!or wfiich applicalion is made and t comply with Ihe State Contradon Law 18.27 RCW and 296.200 WAC �/� <br /> �� l <br /> 'l�l�t�ai �r>L�� $'�$ �I t <br /> OwnerlAulhorized Apanl Sipnature Date (Revlsed L20f iJ <br />