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• • i <br /> PERA�IIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS:���S ���, PROPERTYT %p PERMITQ r O� <br /> LEGAL for new conslruction: Shoh PlaVsuhdivision Lol No._ (altach copy ol long legal descriplion) , <br /> OWNER �1 E L..(�.J Phone/E�mail �Z ' `� <br /> Address � � /{„� �• CirylS�atelZip <br /> APPLICANT: Owner OwnersAqent CoNraclor ConlractofsAgeN TEOJfIt(mus�pm�i4eaieF.orolccnsenllromNeownerm�owwk�nlnas0ace� <br /> CONTRACTOR �W /J L 8 I Lic.# COE Bus. Lic.# <br /> Address PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> `D��f�w 4��ZQ3 -Ga33 <br /> PhonME-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0 <br /> Ezisting Use of Building HEAT SOURCE: <br /> Prote�ed 1�se of Building Gas E�ectnc_ Other,_ <br /> Building type: �Single Family _Duplex_Townhouse _Multi•Family _Commercial <br /> T pe of project: _New Addition _Remodel Repair_T.I._Sign_Sprinkler_Demoiition_Chan e ot Use <br /> DESCRIPTION OF WORK/addrtiona�space provided on the back): <br /> �X/o �o e,<.r�-2 - 3/� 6�,� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJect: _New_Addn _Altoratlon_Ropalr Typo of Projocl: _New_Addn _Altoration_Ropair <br /> how Number(p)ollixturcs Show Number(M)ollixtures <br /> A/C—air handling unils ' / Toilel <br /> � Forced air sys�ems I Bathtub <br /> I Gas piping I Lavatory(wash basin) <br /> � Water heater i Shower <br /> Gas fireplace I Kitchen sink 8 disposal <br /> � s range I Dishwasher <br /> � Cld�hes d er I Clothes washer <br /> Range hood I Water heater <br /> Exhausl fan I Sink(service/bar/mopletc.) <br /> � Heat pump I Backflow preventer <br /> � Unit heater, I Urinal <br /> Boiler \ I �rinking Fountain <br /> � Refrigeration I Floor drain <br /> � Woodstove \ I Grease trap <br /> � Ducling i Roof drains <br /> � Olher I Medical Gas <br /> SPRINKLER / SUPPRESSION,SYSTEM Other: <br /> I Number of Heads � Other: <br /> I�ere6y cetlAy I�al l hava reaC antl eRamined this appliwtion and know tha sama lo be Irua and mrtect.Ail pmvisions ol laws antl oNinancas goveming t�is type oi wark x+tl De romplietl <br /> w�h xTet�er specRieC hereln or not.The granimg o1 e permlt Ooes nat Dresume to give aulhor0y to violate w wncel ine provisbn ol any otMr state or bcal law re9ulating consbud'an <br /> That I am au � C Gy Iha m.ner ol l�ia pmpeny to pedorm t�e work b�xTiN epD�'��tion Is metle onC I wmph wrt�t�e State Contraqors Law 78.27 RC W onC 296 200A WAC. � <br /> Z � , <br /> uthorize Agonl S gnaturo Date (Revised 62072) <br />