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� <br /> �ERMIT APPLICATI� /T�Gt ��1. � <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/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 /> SITE ADDRESS: PROPERTY TA%N PERMIT# <br /> o U C"v 'y�2 ' °� <br /> LEGAL for nerv conslruclion: Short PlaVsubtlrvision Lol No.� (altach copy ol IOng legal description) <br /> OWNER L � PhonelE-mail <br /> Atltlress � d J /7I� � r E � CIIyIStalMZip <br /> APPLICANT._Owner _OwnersAgenl _Conlractor _Coniratlor'sAgeni _Tenanl�mus�o�ov�yenlcnero�conerniwmmeo,m�rnaowon�nir.espan•) <br /> CONTRACTOR C�� , ,�y� Stale Lic. ti City Bus. Lic. �l <br /> �tltlress P�one/Email <br /> CONTACT FOR PERMI? <br /> PhonefE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exisling Usc of Bmlding HEAT SOURCE: <br /> Proposed Use of Bullding Gas_ Elec�nc� oiher_ <br /> f3uiiding type. �Single Family _Uuplex_Townhouse _Nulti-Family _Commercial <br /> Type o(project New _Addition X Remodcl _Repatr_T.I _Sign__Spnnkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(add�;ionai space pmvided on tne back): <br /> nt 'h'/c dT' �F�S7'�� Wa �� T'.�rP'�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ype ol Projecl: �New_Addn X pltvration_Repair Type ol Project: _New_Addn ,Alte�ation_Repair <br /> Show Number(qJ o/Iixtores Show NumAcr(p)of 6xNres <br /> A/C—au handhng umis TodM <br /> Forced air syslems 13aIh1uD <br /> Gas p�ping I.avalary(wash basin) <br /> Waten c�atcr Showcr <br /> Gas frteplace Kdchen sink 8 disposal <br /> Gas ran9c Dishwasher _ <br /> Clothes dryer Cbines washer <br /> --- Range hood Water healer _ <br /> - Exl�awt lan Sink (service/badmople�c ) <br /> I leal pump Uackflow prevenlcr (�nsitle bldg) <br /> Uml heater Unnal <br /> — -Eloilcr --- �Dnnking Pou�lain _ <br /> Re(rige�atior� Roor dr�in <br /> , Woodstove Grcase trap <br /> Duc�inq -- � f2oo1 drains <br /> Olher -- — �-- MedicalGas _.. <br /> SPRINKLER I SUPPRESSION SYSTEM olhcr <br /> _I____IJumbr,r of Hr.ads Olhcr. <br /> I hrreby cehily Ih:il I have read and e.amineJ ihis appLcatlon anC know t0e same lo Go Iwe and mrrecl.All provrsions ol lixs.n0 ortlinances goveming Ihi,lype ol wvM1.wdl Ce cm*iu��'� <br /> wJn w�ct�cr speciGed hercin oi nn1 ihc nranlin9 0l o permd Docs nol piesumc l0 9rvc nut�only lo violale or canccl l�c provision ol any ol�cr stalc or lowl law rc9uWbny consboct�un <br /> Th;:l I rm:mlhon+ed ny Ihc o �ncr ol lhi^prope�y b pcAarm I�c viork br w�ich apPlrahon is matic and I rnmply wilt�IAe Slaic Lonlrar.lors I aw 18 27 NCW and 796 200F WAC <br /> �_ Z� S <br /> Owi PrlAu lori cJ AgCnl Signa�urc S� Ualo' (l7nvi�;�,d��/7U16) <br />