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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES � �� -rj—�(f <br /> 3200 Cedar St., Everelt, WA 98201 425-257-8810 FAX 425-257-8857 www.e�Itpy��r� <br /> Y� <br /> SITEA�DRESS: raorEarvinxa P RMIT <br /> �� ( <br /> LEGAL lor new conslruclion. Shor1 PlaVsubdiv¢ion Lot No (aitach capy ol long legal tlescnption) <br /> OWNER � � PhonNEmad <br /> Atltlress Gty/Stale2ip <br /> APPLICANT:_O�vner _Owner'sAgenl __Com�acler ComracloYSAgent _Tenant�m�sipro.�oaaie��.�rciu-,:c�i��ominoo,.r��r�om»oM�:ie•.osaa:�� <br /> CON7RACTOR �/u,cf,� � State Lic �3- �� - 7y° � City Bus. lic Z��Z3 <br /> Atltlress � � V �. � Phone/Ema�l � ZS3-z�a-3�,S-3 <br /> TENANT BUSINESS NAME ONTACT FOR PERMIT <br /> PnonelE�ma�l <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK�—_� <br /> Existmg Use of Building Sr2 NEAT SOURCE� <br /> Proposed U� �Iding_ Gas___. Eleclric Oiner_ <br /> Building typ X 5 ngle Fam�ly� uplex_To��nhouse _MuVi-Famtly _Commercial <br /> Type of proie New �1dd,hon Remodel Repair_TA. _Sign_Sprinkler_Demoldion_Change o(Use <br /> DESCRIPTIONOFWO��Ki���'��'���•�'-'l-�3ceprov�tledonrneo�cw) L.t.__ �,�(.�/���( , p�C.�C– � �'N �"'S. <br /> ^ S}�� Cy,n�.c-li� nai�..�� �i�6S �`toilf{5 i��(�at �..-.�/� /�,{��Ciunc.c5 ji.,5L2�ctt�7+�r <br /> �j���-e, <br /> ,vdY-c.!'cn_S . eK.c( O'y 3�ncvLS ., ccn1,C dyyc._ [LvcJz . � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: _New_Addn _Alleration_Re�air Typo of ProjecC _New_Addn _AlleraUon_Repatr <br /> Show Number(k)a/li.fures Show Number(kJ oI lrxfures <br /> AfC —air handling unds Z ; Toilet <br /> � Ferced a�r systems � I Ualhtub <br /> j 3as pipmg I Lavalory (wash basm) <br /> � Water heater I I Shower <br /> � Gas fireplace i Kdchen sink 8 disposal <br /> Gasrange I Di5hwJ5hE� <br /> � Clothes dryer � Clolhes washer <br /> � Range hood Waler healcr _ <br /> Exhaust lan Sink (servicN6admopletc) __ <br /> Flcal pump I Backflaw preventer __ <br /> UnR heater Unnal <br /> Boder i Drinking FouNain <br /> � Refngerelion � Ploordratn <br /> VVoodstovc � Greasctrap <br /> DucGng � Roof dralns <br /> I p���e� tvledical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM o�her <br /> I NumberofHeads � Other. <br /> Ine�eCyccLtyihatlh�rverc;idan0e�aminetll�isaDPl:cahonandAno•.vlhesamelo6elmeandcorrcct AllpmvisionsallawsandorElnances9ovemingl�islypem..a�kw�7becomF��ea <br /> wnn wnethm specdie0 neiein or nm Tne 9ranlin9 0l a pernnt aoes not pmsume lo give nutnonly to vioiale or cancel ihe pwvis��on ol any o;ner state or lowl law regulann9 wnswciion I <br /> Ti+al I am�ul�on:etl the o�c� oi�Rs pmCeny�o petlerm i�e r�ork lor w�rth appiiwiian is maae anE I mmply with I�r Sfate CoNracteis Law iB 27 ftCW an0 795 200A WAC � � <br /> - - �U 'Z ZO(�l <br /> dAulho zed Agent SlgnaWre Dale (Fevisetl3i207JJ <br />