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+ PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/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 /> APPLICATIONS ARE ACCEPTED FROM t AM TO t PM <br /> SITEADDRESS: I,y2,5 � • A� �p�S� E�� ��II <br /> � K, �.� 100110� ZO <br /> LEGAL ta new conaW dion: Sho�t PlaUsubAivision Lot No._ (olt�ch coPY ot brg kpal de�criptbn) <br /> OWNER 0��1 VAi�� � PhoneiE-mad "C1T'3!�'�� <br /> Ad�recs ���•f C�L ��yc,. CltylSlate2ip ' �A 4v" � <br /> CONTRACiOR •I� i�lY �.��1 L81Lic.lf O�F�1 bDO <br /> AAdress (7��•� � e Jf' S£ S}'� 1'f P,w'1'Q r�l l �.11• PMndEmail �' (7-7� 77u► <br /> TENANT BU INE N E CONTACT FOR PERMIT T� � <br /> M�2•FIM �)tw.r�vt 3(w-71q-�116 ,� � wlfl�R ta+. <br /> Phona/E�+nail <br /> BUILDIN6 PERMIT APPLICATION CONTRACT PRICE OF WORK 4 00 <br /> Existing Use of Building ��� HFAT SOURCE: <br /> Proposed Use of Building �r�'�'� ,/ Gas Ekaric Other <br /> Building type: _Single Family _Duplez_Tovmhouse _Multi-Family M1 Canmercial <br /> Type of project: _New _Addition _Remodel _.,Repair�T.I._Sign_Sprinkler_DemolHion_Change of Use <br /> Description of Work(edddionel space provic'ed rn fhe badp: 'f� <br /> Qva►ae �� n�w Ps�«�+ =r� b��w.� ci��A� � �Csh•n�rt� <br /> Have you started workinp without a pertnit7 _YES �,NO <br /> MECMANICAL PERMIT APPLICATION PLUMBIN6 PERMIT APPLICATION <br /> iyp�olProJ�et: _New_AOdn _All�nNon_R�pdr TYp�otProJ�tC —p�'�Addn _AII�Mbn_l4WIr <br /> ShowNumber o/flxWns SfawNwnMr olflrWrea <br /> AIC–airhendlin units Takt <br /> Forced air s stems Bathtub <br /> Gas i in Lavato weah basin <br /> Water heater Shower <br /> Gas fire lace Kilchen sink&di sel <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Weter heeter <br /> Ezhaust tan Sink aenicelbar/mo etc. <br /> Heat um Badcflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlein <br /> Refri eration Floordrain <br /> Woodstove Greaee tra <br /> Dudin Roof draina <br /> Other Medical Gae <br /> SPRINKLER / SUPPRESSION 8YSTEM Other: <br /> � Number of Heads Other: <br /> I hereby ceAiy thal I have read and examined this appliwtion anE know the same to be true an0 corred.All provi6bns ollaws aM adinances govemlrp <br /> this type of work will be complied with whetl�er epecified herein or nol.lTe granting of a permil does nol presume to gNe authority to violNe or c�ncel <br /> the provision oi eny other etate or local law reguietinp construciion or the peAortnence oi wnslnid'an.Thel I am authorizaA by tM owrMr oi Mis property <br /> to peAorm the work tor which application is maAe arb I comply xdth lhe State COMredors Law 78.27 RCW and 298.200 WAC <br /> ����Iti <br /> pwrror/AuthoAzaA A ign�turo D le (Revissd?/2011) �� <br />