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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CI7Y OF EVERETT PERMIT SERVICE$ <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wwv+.e��erettwa.org <br /> U -ia-�7.. <br /> SITEADDRESS: � PROPERTYTA%N PERMITI� <br /> 7�( ' <br /> LEGAL lor new constmclion: Short PlaUsubdivision lol No._ (attach copy ot long legal descriplion) <br /> OWNER q� <br /> C�� Phone/E-mail Z�� — �� <br /> Adtlross {.(/ '(GiA"T—' �i�. CilylStale/Zip lA�� <br /> APPLICANT:�O�vner Owner'sAgenl CoNractor COnl�3[lo�'SAge�t _Te08n1(musipronaeaienero�wne3nitrcmmao.��ne�maoworkintneapnce� <br /> CONTRACTOR .�1� �� Slate Lic.# City 6us. Lic. # <br /> Address Phone/Email <br /> iENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phonc/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use o(Building en e / HEAT SOURCE: <br /> Proposed Use ot Building Gas___ Eleclric_. Other_ <br /> Building type: �Single Family _Duplex_Townhouse _Multl-Family __Commercial <br /> T pe of project: __New _Addition emodel _Repair_T.I.,_Sign_Sprinkler_Demolition_Change o(Use <br /> DESCRIPTION OF WORK�addrtional space providedon ihe ba k/: <br /> ,�cac� b�tf�h, ��re�, a� S,v�K <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProjoct: _Nnw_AAdn _Altoration_Ropair TypoofProJuct: _Now_Addn _Altoretlon_., epalr <br /> Show Nunrber(q)ol/ixtures Show Num6er(t!)ol fixturcs <br /> � A/C—air handling units I Toilet <br /> � Forced air systems � Bathtub <br /> � Gas piping I Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace I Kitchen sink 8 disposal <br /> � Cas range Dishwasher <br /> I Clothes dryer I Clothes washer <br /> � Range hood ; Water healer <br /> Exhaust fan � Sink(szrvice/bar/mop/elc.� <br /> Heat pump � BackOovr prevenler <br /> � Unit heater I Urinal <br /> � Boiler I Drinking Fountain <br /> I Refrigera�ion j Floor drain <br /> � Woodslove I Grease lrap <br /> Ducting � Roof dreins <br /> � Other i Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Othec <br /> Number of Heads � Olher: <br /> I hereby cen�ly Ihal I nova ieatl antl examined thls applicaGon and kno�v t0a same to ha Irua and rorrect.All provisions ol laws end orCinances goveming this typa al woik vntl be ronplietl <br /> �arJ���hetner spen�etl�erem or not.Tna gianting ol a permit Cces not pmsuma lo gNa autnority to violata or cnncal l�e pmvisron ol any olner stete or bwl law reguleting consbuction <br /> That 1 am authorized by I�c owner o11Ns D�openy to pedorm tho work far whL•�appliwtion U maEa onE I wmply wtl�I�e Slate Contra;ton Law 1B 27 RG.V and 296.300A WAC. <br /> OwnorlAuth�nl� ur� � �a�/ �I� (Revised3l20f3) <br />