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i <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8657—www.everettwa.org <br /> APPLICATIOPIS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS:4ZO P2�I( PIBC@ PROPER7YTAXbOOGOB2OO000IOO PER�IZO ^- � <br /> LEGAL for new construcUon. Shon PiaUsuDtliviswn Lot No_ (attach wpy ot long legai aesu�ption) <br /> owNeRMegorden Nathan E � Sarah J phonelE-ma�l <br /> naa�e55420 Park Place c��r�s�a��rz�aEverett, WA 98203 <br /> coNitincrort Saulh Counry piumbing �8 t Lic u SOUTHCP19302 <br /> ad�essPO BOX 6157, EdmOrtds WA 98026 Pno�eiema�i425 775 7377 <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> cu stomerserv ice@sou Ihcou n typlumbi ng.com <br /> Phone�E-mail <br /> BUILDING PERMIT APPLICATION CONTaaC7 PRICE OF WORK I9D (� <br /> Ezisting Use of Building single family residence HEAT SOURCE: <br /> Proposed Use of Building same Gas_ Eiectnc_ Other_ <br /> Builtlingtype: �SinglePamily _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition ,�' Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DeSC�iptionOfWork(atldrfronalspaceprovitledontheback): by(hf00111fBfTlOd@I, installnewtub/showerand <br /> valve. relocate vanity sink drain. install new <br /> fixtures at finish <br /> Have you started working without a permit? _YES "NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Projecl: _New_Addn _Allera�lon_Repa�r Type ol Project: _New_Addn Alleration_Repalr <br /> Show Numbcr fbl o!lixtures Show NumDer(al o1lrt�res <br /> A/C—airhandlingunits I Toilel <br /> � Forced air s stems 1 Bathtub <br /> Gas pipin Lavato (wash basinl <br /> � Water healer Shower <br /> Gas fireplace Kilchen slnk 8 disposal <br /> Gas ran e Dishwasher <br /> Clolhes d er Clothes washer <br /> � Ran e hood Water heater <br /> Exhaust lan Sink(servicelbar/mop/etc.1 <br /> Heat pump Backflow preventer <br /> Umt heater � Urinal <br /> Boiler ' Drinkin Founlain <br /> Refri eration Floor drein <br /> Wootlstove Grease trap <br /> Duchn Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads � Other: <br /> I hereby certdy ihat I have�ead antl esamined ihis apphcation antl know the same to De We antl wrtxt.All provisions o��av.s and ortlinances goveming <br /> �hi5 type ol work will be[omDlied xUh Whether Specdietl hemin or not.The graniing ol a permit tices nol presume lo give aul�onty to viol0�e or CanCei <br /> ihe provi5i0n ol any olher Slaie or lotal law regulatmg conSWdion of lhe peAormanCe ol ConSINCIiOn That I am aulhOnied Ey Ihe Owoer OI I�iS properiy <br /> to pertorm re work lor wh�ch application is ma antl I comply x+lh the Slale Comractors Law 7827 RCW and 2°5 200 WAC <br /> 5 <br /> AWhodzetlA9entSlgnN o ae fRevised220tt� <br />