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( <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES I —ab��Z <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org � Ob� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �(.� � <br /> SITE ADDRESS: RERM TA <br /> S�OoZ �Q,�/c v�ecv�ii o��c�`i"30000 a3 00 <br /> LEGAL lor new consiruclion: Short PlaVsubdivision Lot No._ (attach copy af long legal descriplion) <br /> OWNER U/"� �d/'�i� � iS l�/h� �'honelE-mail y�5 3 S'S- �� 96 <br /> AAdress � Q Par'�F K��' �n CitylStale2ip �{/��" L W/"� J � <br /> CONTRACTOR L 8 I Lic.# <br /> Address PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT � <br /> Phone/E-mail � / • �� � � ��� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building e u�e �y HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ o�her <br /> Buildinglype:�SingleFamily ,_Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair T.1._Sign_Sprinkler_Demolition�C�iange of Use Q�� <br /> Description o(Work(edditional spece provided on Iha back): /I QQ ,,,�p��� .� ,S� <br /> w� rtze-oC �o �'��°L4cer��-.�"'`� ,6ac� deck's. <br /> Have you started working without a permit9 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeotProJecl: _,New_Addn _Alteratlon_Ropalr TypeofProject: _New_Addn _Alteration_Repair <br /> Show Number(MJ o//ixfures Show Number(MJ o1 Rxtuies <br /> AIC—airhandlin units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavato (wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaustfan Sink(servicefbarlmop/etc.) <br /> Heat pump Backflow preventer <br /> Unil heater Urinai <br /> Boiler Drinkin Fountain <br /> Re(ri eralion Floordrain <br /> Woodstove Grease trap <br /> Ducling Roof di:ins <br /> Olher Medicai Gas <br /> SPRINKLER / SUPPRESSION SYST�M other: <br /> Number o(Heads Other: <br /> I hereby certify Ihet I have read and ezamineC lhis application and know the same to be lrue and correct.All provisions of lews and ordinances goveming <br /> �his lype of work will 6e complied with whether specified herein or nol.7ho granling af a permll does nat presume to give authority lo violale or wncel <br /> the provision of any other slate or tocal Inw reg ing consln�ction or the peAormance of conslruction.Thet I am aulhorized 6y the owner of ihis property <br /> to peAorm the work for which a io ' i de nd I comply with ihe Slate Conlractors Law 18.27 RCW and 296.200 WAC � <br /> 08_ >�- aoi� `lZ <br /> OwnorlAuthorizod Agont Signal ire Da�e (ReviseJYt01 ij <br />