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�' �.. <br /> PERMIT APPLICATION <br /> BUILDING/M'ECHANI�CAUPLUMBINGISIGNISPRINKLER/DEMOl.4T10N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRE� PNOP�R7Y7A1tN M � � <br /> .7 �'S I <br /> LEGAL for new conslrucllon: ShoR PlaUsubdivlsion _Lol No._ (attach copy of bng legal desalpibn) <br /> OWNER / �� 2C✓"✓t� PhonelE-mall yL�� �/L� 7 � L`�Tv p2�3 <br /> ddrees � — � CitylSletalZip L✓t!��� / W �Z� } /— 7Y� <br /> -� � �Z. <br /> CONTRACTOR � (s71— LU /� L 81 Lic.# �C C � S � �� ����� <br /> — �{ ,1 /1(1 1��� c l,9e�J� PnonelEma�l 34,c� — SG-:l' 97.��/ <br /> ddres� �j l ' l�✓JS/K7l�� <br /> TENANT BUSINESS NAME CONTACT F�R���, �2��y�LyL <br /> PhonrJE-mall L� ��—� � ZJ v. <br /> BUILDIN6 PERMIT APPLICATION CONrRACT PRICE oF WoaK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gea Electric other <br /> Building typa: _Sfngle Family _Dupiez_Townhouse _Multl•Femily _Commarcial _ <br /> Typa of project: _New _Additfon _Remodel _Repeir_T.I.,_Sign_Sprfnkler_Demolilion_Chenga of Use <br /> Descriplfon of Work(addHional spaca providedon Ihe bacx): <br /> Have you started working without a permit? _YES _NO <br /> MECMANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJect: _New_Addn _AlteraUon_Repalr TypeofProJect: _New_Addn _Altentlun_Repalr <br /> ShowNum6er(p o//drtures Show Num6er )ol flxfwea <br /> A/C-airhandlln unils Toilet <br /> Forced air s stems BalhWb <br /> Gas i in Lavato wash basin <br /> Water heater Showar <br /> � Gas fire lace Kilchen slnk 8 dis osel <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaustfan Sink sarvicefbar/mo /elc. <br /> Heat um Backflow reventer <br /> Unit healer I Udnel <br /> Boiler Drinkin Fountain <br /> Refri eralion Floordrain <br /> Woodslova Greese tra <br /> Ductin Roof drains <br /> Olher Medlcel Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number oi Heads Other: <br /> I hereby certiy ihat 1 havo read and ezamined ihis appliwlion and know Ihe same to te lrue and cwrecl.All provislons of Iaws end ortlinances 9%'eming <br /> this type of vro � complied with whelher specifed hereln or not.The gronling ot a permit does not presume to give eulhonty lo violale or cencel <br /> thn provislo ol any o er slal r I law reAulating constructlon or Ihe peAortnance ol consWclion.Thal I em euthorized by lhe owner ol ihls pmperty <br /> lo peAorm 11 '�vork f wfil � p lication Is made and I compN"+��h�he Steta Contracton Law 78.27 RCW and 298.400 WAC <br /> �, y-i� -Iv <br /> OwnerlAuthodzedA l5 �uru Date (Revlsed?/101f) <br />