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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-7.57-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �SITEADDRESS: � PROPER7YTAXp ��TIZ�O'W <br /> �ZUZ (�Qc�s ✓� <br /> LEGAI.br new consWction: Shoh PlaUsubdivislon Lol No._ (attach wpy ol long legal tlescnption) <br /> OWNER / ' S TI i I�LG�- Phone/E-mail <br /> Address �cn./�� �/ aG./��5�- CitY/51atGZip �'�U�iUiZJf <br /> APPLICANT:_Owner OwnersAgent Comractor Conlractor'sngenl TenaNtm�s�o��ba.krera�ca�samm>mm.wa�e.ioaa+on��nne.c.cet <br /> CONTRACTOR Ifj ,pi7 �:7/ P _/» .!' 1-8�Lia# ^ fiC//��OE Bus.Lic.# <br /> Adtlress �L�l/J /('/- � (} �hs� -1�/�ZU/'C� Phone/Email !�C 5 � 37�'/� .J�� <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> /-j7l/�/ /"/L��L��;r�/f'//i-�� Phone/E•mail i1�� `�� 7 ��/��� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE oF WORK � <br /> Existing Use of Building S U � 'X '^�� �t�2�'7 C;2 HEAT SOl1RCE: <br /> Proposed Use of Building G7�� �� OIl G k�7 ��L����"J Gas_ E�earic Otner_ <br /> Building lype: �Single Family _Duplex Townhouse _Mulli•Family _Commercial <br /> T pe of pro'ect: New Addilion �Remodel _Repair T.I. Si n Sprinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK�atlCitional space pmvidedon fne Gack): J /� ' <br /> �'��/L� �l'J'Lc>G'11 �2C�.G�GSG� K��' , <br /> _/ .�Jr:'lOr ul..I :�g //,��� �L���/�[--� �'/ / <br /> �7/ i ' L/ <br /> t�(1G��.�OS'i ��-2:vtZ �X� l,LccZ�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typeo(ProJecl: _New_Addn _AlteraUon_Repalr TypeolProJecl: _Now_Addn _Alleratlon_Repalr <br /> Show Numbcr(N)ol/lxiures Show NumLei(b1 0l llxfwes <br /> A/C-air handling units Z Toilet <br /> Forced air s slems Z I Bathlub <br /> Gas pipin Lavatory(wash basin) <br /> Water healer Shower <br /> _\ Gas fireplace Kitchen sink 8 disposal <br /> � Gas ran e Dishwasher <br /> Clothes dryer Clothes�vasher <br /> � Ran e hood Water heater <br /> Exhaust fan Sink(servicefbar/mopletc.) <br /> I <br /> Heal pump Backflow preventer <br /> Unit heater��� Urinal <br /> Boiler � Drinkin Fountain <br /> Retrigeration 2 Floor drain <br /> Wuodslove \ Grease Irap <br /> Ductin \ Roof drains <br /> � Other Medical Gas <br /> SPRINKLER / SUPPRES.c,ION SYSTEM Other: <br /> Number ol Heads Olhec <br /> 1 hereby eetlM lhat i hava read anC ezamined Nie nOP�tiolan ontl knrnv t�o fnma to Ea teuo antl cortect.A7 ymvisiom ol lawa ond arCnan<n 9a�emnB��u typo olwoM n+A�e comp4eC <br /> wnh whother spetifmd nercin or nol.Tho Bmnting ol a permit Gom nol presume to pNe nuNony Io Wc'�lo or cnncel Ilio pmvishn ol ony oNer slale or locnl law re9ubtinp conslruciion <br /> ihal l am nuNodxM Ey I�a rnvner o!I�is pmpeM lo pedorm 1ho wo�k lorw�kh appGcntbn b maCo ar,Q I compH wAh Iho Steio Canlrncton Law 7827 RCW antl 298TOOA WAC. <br /> ".j - —% �!�'��'�'z (/L <br /> Own f4�/ ut odzed A�Gn 19nature Da�e (Revised N20f2) <br />