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� � � PERMIT APPLIC/�TILN <br /> BUILDINGIMECHANi^ALIPLUMBINCiSIGNISPRINKLER/DEMOLITION <br /> ChTY OF EVERETT P ERMIT SERVICES �j- 19�-I( <br /> 3200 Cedar St., Everett.U!A 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEP7E0 FROM!AM TO 4 PM <br /> SITE ADDRESS: VNO�EIITY TIU(11 PERMIj.N/ O <br /> �A�r�E KIEtO WhY Eu'-,GtFT WA �.,.-��'7 �� � <br /> LEGAL br new construction: Short PlaVsubdivision�+:w1kST�E�°�GeS�_Lot No._� (a8ach copy M lonp legal descnplion) <br /> OWNER _ �_ �(.��5 NvJ lLC Phone�E-mau �`1Z5� 33,�i 'S5� L <br /> noaress Pa 6-�x 14'�z`i COy/State2ip M�..� Cw�K WA `1{�'� <br /> CONTRACTOR C,�RrJ=2s-�, � I-IoMcS N�J L1,C L81Lic.lf C�%RNt I-IN `14l L A <br /> (vi5 33�' S:��� <br /> Address �u Qu7� ���`{Zy (�'\lu �.F.'E�k �Jk 9�Jt2 PhonelEmail ,��(11{�y�N��StiN_H�MES,UL <br /> TENANTBUSINES�HAME CONTACTFORPERMIT �„�A� iMPo�R <br /> Phone/E•maiil�12s�33�-5555 M�Qc,-I:H'�+nnr_�iti.,cS.uS <br /> BUILDING PERMIT APPLICqT10N CONTRACT PRICE OF wORK_ <br /> Existing Use of Building________________--________-- HEAT SOURCE: <br /> Proposed Use of Building_________ ___— Gas_X_ E����____ ��her____ <br /> Building type: X Single Family ___Duplez_Townhuuse __Multi•Family _Commercial <br /> Type of project: _�New __Addition __Remodel __Repair__T.I._Sign_Sprinkler__Demolition_Change of Use <br /> Descriplion o(Work(additional space provided on fha 6ack�: <br /> [3As� � � �1i3 (P� I � c�� �) <br /> Hava you atarted workinp without a pertnil7 __YES �NO <br /> MECHANICAL PERMIT APPLIC�4;iON PLUMBING PERMIt APPLICATION <br /> Type ol ProJecl: `�New__Addn _Aller�Uon___Repelr Type of ProJect: �New_AdAn _Alt�ntlon__Repair <br /> ShowNumbar N)o/flxturoi SAowNumWr M olflctuns <br /> A/C-air handlin units 3 Toilet <br /> Forced air s stems 2 °3thWb <br /> Gas i in Lavato wash basin <br /> W ater heater Shower <br /> Gas fire lace I Kitchen sink 8 dis sal <br /> Gas ran e Dishwasher <br /> Clothes d er 1 Clolhes washer <br /> Ran e hood Waler heater <br /> y Exhaust fan Sink service/bar/mo /etc. <br /> Heat um BackOow reventer <br /> Unit healer Urinal <br /> Boiler Drinkin Founlain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin Rool dreins <br /> Other-------------- Mediral Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> I Number of Heads Other: <br /> I hereby ceAily Ihat I have iead and ezamined this applicalion and know Ihe same to be true and cortecL All pmvisans ol lavrs and ordinances poveminp <br /> Ihis type of work will be complied vnth whelher speciGed herein or not.The granting of a pertnit dces nol presume to give authority to violale or cancel <br /> Ihe provision of any olher sla�e or local law regulating conslruclion or the peAormance of consWdion.That I am euthonzed by the owner ol this propeRy I <br /> to peAorm Ihe wvrk for wfiich applicalion is made antl I complywith the Stale Conlraclors Law 18.27 RCW and 296.200 WAC � ^ ' <br /> �,+ � /i <br /> Y!1 w ^,,L+i $ I 5 �I l <br /> R <br /> OwnerlAuthorized Agant Sipnatura Date (Revised 2/20f1/ <br />