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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLI710N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-6857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERiYTA%if PE�T�5 'OO <br /> �o ll oG.,�a fl✓e <br /> LEGAL for new wnslruction: ShoA PlaVsubdivislon Lot No._ (attach cop/of IonB�e9al dewipllon) <br /> OWNER �•(Gr+'�I- �t PhonelE•mall 2-�� 07d• 6Y <br /> ddress 3�zS. Zgpf� S�' �/_�✓ S�n c� a�r�sie�e�nP S{an aca� �.l _ Q8Z9Z <br /> CONTRACTOR L&I Lic.# <br /> PhanelEmail <br /> ddress <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phon�JE-mail <br /> BUILDING PERMIT APPLICATION coNiruc7PaiceoF WORK <br /> Exisltng Use of Building HFAT SOURCE: <br /> PfopoSed U58 of Buiiding Gas Eleclric Other <br /> Buildingtype: _SingleFamily _.Duplez_Townhouse _Multi•Family _Commercial . <br /> Typeofprojecl: _New _Addition _Remodel _Repeir_T.I._Sign_Sprinkler�.Demolitlon_Change otUse <br /> DescripUon af Wofk(addifional spam provldedon Ihe 6ackJ: <br /> �ew�� Re�,r ryv4SL <br /> Have you started working wilhout a permit7 YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJecl: _New_Atltln _Alteratlon_Repalr TypeofProJect: _Naw_Addn _Altaration_Rep+ir <br /> Show Num6er(M)o/Oxfures Show Num6er(NJ o/flxt�ros <br /> A/C-air handling units Tailel <br /> Forced air s stems Balhlub <br /> Gas i in Lavato wash basin <br /> � Waler healer Shower <br /> � Gas tire lace Kilchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clolhesd er Clotheswasher <br /> Ran e hood Water healer <br /> Exhausttan Sink service/barlmo /etc. <br /> Heat pum Backilow raventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> � Woodslove Grease tra <br /> � Ductin Roof drains <br /> � Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> Number of Heads ( Other: <br /> I hereby certiy that I havo read and examined this application and know lhe same to 6e Irue and correcl.All provisions ol laws and ordinances goveming <br /> this typa af work will be wmplied aith whether specifed hereln or noL Tho granling of a permil dces nal presume to give auNority lo Wolata or wncel <br /> Ihe provision ol any other stale or Ixal law regulaling consiNclion or the peAormance of consl�uction.That 1 am authorized tr/lhe owner ol thi�properry <br /> lo pedorm tho work fa which applicatlon Is made and I wmply with Ihe Slate Contracton Law iB.27 RCW and 288.200 WAC <br /> � / <br /> rw ,l�a�.-�,� 5- 2y-�Z <br /> Owncr/ uthor edAgantSignalura uale (Revised7/101Q <br />