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: " � PERMIT APPUCATI�i�� <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES ..-Q 7�. <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257•8857—www.everettwa.org /( <br /> APPLICATIONS ARE ACCEP7ED FROM E AM TO 4 PM <br /> SITEADDRESS: VnOPERirTAlt« PERMR�/D I <br /> p L YA�rJ6 FiE�� WhY EvERET WA �.:17 <br /> LEG�r.for new construction: Short PlaVsubtlivision G:��S��Co����_LW No._�p (atlach copy ot lonq legal ne�;;��{�) <br /> OWNER � <br /> � �� ofha.S NW U..0 Phone/E-mall �4Z5 33✓ -55� G <br /> naa�ess (�0 8.,x 14�z`1 City/StateRip M�� C.�-e�K WA y:o:2 <br /> CONTRACTOR (_,o� =a5-t � Ea�M�:.s N�� U.0 L61Lic.q C�RNcI-IN `141LA <br /> C4iS i3. -5%:.i: <br /> Address Pu Qu7� ���yZy ���u. �.f.'EEIC �1�4 9`Ci.1�tiZ Phone/Email ���n��;�N„gtiN�M�MES.ui <br /> TENANT BUSINESS HAME CONTACT FOR PERMIT r,�qn- �M P��.� <br /> Phone/E-maill�{25�33'L-S555 M�trQc,..:;N�nnr_��..;n�S'.US <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ , <br /> Existing Use of Building__�____� — HEAT SOURCE: <br /> Proposed Use of Building ____—__--- Gas_X_ Eiectric____ Other____ <br /> Building lype: X Single Family ___Duplex_Townhouse __M:;iti-Family _Commercial <br /> Type ot project: �New ,Addition _Remodel _Repair_T.I.�Sign_Sprinkler__Demolition,Change of Use <br /> Desc�iption of Work(addifional space provided on Ihe backJ: <br /> [�a-S� c � �I I Z �n�/�-n/ I l `1 S 6� <br /> Have you started workinp wilhout a pertnit7 ___YES _�NO <br /> MECHANICAL P�RMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pro�eel: �Naw_Addn __ Alleratlon___Repair Type of ProJacl: �Naw__Addn _Alt�ntlon__ R�pair <br /> Sltow Numbar � ol Rxturet Show Numbar N o/flaYuns <br /> A/C-airhandlin units 3 Toilet <br /> Forced air 5 slems 2 Balhtub <br /> Gas i in Lavato wash basin <br /> Waler heater Shower <br /> Gas f re lace I Kitchen sink 6 dis sal <br /> Gas ran e Dishwasher <br /> Clothes d er ! Clothes washer <br /> Ran e hood s.� Water heater <br /> y Exhausl fan Sink servicelbar/mo lelc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinki Fountain <br /> Refri eralion Floor drain <br /> Woodsrove Grease tra <br /> Ouctin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certily ihal I have read and ezamined this applicalion and know the same to be lnre and cortecL All provisions ol laws and ordinances goveming <br /> Ihis type of Nark will be complied with wfiether specified herein or nol.The granting ol a pertnil dces nol presume lo give aulhorily to violale or cancel <br /> Ihe provision of any olher stale or local law regulaling construction or�he peAormance of wnstruction.That I am authorized by lhe owner ol lhis property <br /> lo peAorm�he wvrk lor which applicalion is made and I comply with the State Contractors Lew 1827 RCW and 296.2J0 WAC <br /> Yl?Rw �,.,,tp� 8'I$ �I I <br /> OwnsrlAuthorized Agant Sipneture Date (Revised 2l20;� I <br /> /a <br />