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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl,WA 98201 -425-257-8810—FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADDRESS: PPOPERN TA%tt PEF�{d1T N <br /> �. �y -s � �� � �l ��- /.J Z' <br /> LEGAL fer new construclion: Shoq Plat/subdivision Lol No._ (allach copy ol long legal Cescripiion) <br /> O�VNER GI - E -" P�onc/E�mail 25•.25 • ¢ 7 ' <br /> nd���ss 3 DI GLf�ll'L S —L=T crtr�siaiaz�a V�1� � `��.1'Dg <br /> CONTRACTOR L&I Lic.# <br /> Ad:ress P�one7EmaJ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT�-��{s �i_ �-'�� <br /> �— ��� - J ..� P�cnME-mailGlAV'kC� GI , eV�V'G G..• �✓ <br /> BUILDINGPERMITAPPLICATION coNTRn,crPRICEOFWORK 4ro S <br /> ExrslingUseofBuPding nl-t-lG� - �.,� �-A�f`��� '✓ HEATSOURCE: �'�' o�o <br /> Prcposed Use o(Building���-� - ����-����C^ G�s_ Electric omer_ <br /> Building type: _Single FamBy _Duplex_Townhouse _�dulti�Family X Commercial <br /> Typeolproject: _Neri _Addition �Remodel _Repair_T.I._Sign_Sprinkler_Oemolition_Change alUse <br /> �e5aiplion Of Wofk(atled�bnal space povided on Iho CacNJ: <br /> �����1�� (rn�aJCM�,sTs � P-t��� �-��-� W�21� C�=��Y�_1�1�) <br /> �� <br /> Havo you sWrted workfng withoul a permit7 _YES �NO �. Nl� �Y/ �� � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypaolProJec�: ,_New_AdEn _Alleralion_Repalr iypuo�Projecl: _New_Addn _Allera�lon_Repair <br /> Slmw Num6er(a�ol Ilrfures Shmv Num6cr(AJ ol llrtures <br /> � AIC-air hand!ing units I To��el <br /> � Porced air systems � Balhtub <br /> Gas C�C�n I Lavato (wash basinj <br /> � Water heater � Shoyeer <br /> � Gas freplacc � Kitchrn sink 8 dispcsal <br /> Gas ran e I Dishvrasher <br /> Clothesd er I Clotheswasher <br /> � Ran e hood � l'later heater <br /> Exhaustlan � Sini(serv:cei6ailmop/etc.) <br /> Heal pump I Backflow preven'er <br /> Umt heater Urinal <br /> Bader Or��nkin Founlain <br /> Relrigeralion Floor drain <br /> � 6Veodstove I Greasc irap <br /> - � p����,�� — � Rocltlrains <br /> � Other hleGiwlGas <br /> SPRINKLER I SUPPRESSION SYSTEM I other: <br /> � Num6er of Heads I Other: <br /> i:ere,�cemry�t�I I��:a read an0 e*amiried ir.�s a,F�caGon a�a�no.v tt+o same to Ce true a�d ccrteq.Atl provlsbn� ol ia+vs and ord�.�aixes goverrtng <br /> . .;q po c1 xcit ;:'i�^.comF'�ed vn:h whether spec�'�ed t+�re:n cr nol.TTe B�anlinp ol a perm�.t doef nci pres�me lo grvo aufno'���y lo rolate c�cancel <br /> ^o provision ol a:.�o"+er sl�!a or Ixal lan requtating conslruclicn or t�n pe�ortnance of cons'.ruction.Thal I am autlwtlaed b/tho w.ner cl�h��e properYy <br /> •�Fcrtam Iha wo�h!a e•hlrh appircafon is made anA 1 eompy e�th Iha Stale Conlroelon Lax 1B Z7 RCV!and 298 200 WAC <br /> �'y��� LAl/�.1� �� -Z� � <br /> OwnedAN oriitd P9ent Slgna�uro � � ��'a (ReviteJ�O1Q <br /> Z <br />