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� i <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereri, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 MI TO 4 PM —/7 �I� <br /> SITEADDRESS: /_� I ` �EQ'�I6L �RKIC QKl/ P�LZj6L��(�30 � 3�0 PENR� (�cS '��✓ <br /> l0 <br /> LEGAL for now conslruclion: Short PlaUsubdivision Lot No._ (etlech copy ot long legal doscription) <br /> OWNER S �JJ(.'1T0 �7�J�-V�NC't..$ PhonelE-mail <br /> Address CiryiStete2ip <br /> CONTRACTOR � K f�I l � �s i u�.a ST G(I�) I <br /> Address S 2 2.N, �'�' K-U�_Vv� PhonalEmail ZOCD- S-TS ' / 5 Z I <br /> NANT 6USINESS NAME CONTACT FOR PERMfT '�V D Y'�� � - <br /> ��jl..(�I PhonelE-mail '�J7 '-ISZ� b c.7 1����+• � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WOR N d�, C�d O <br /> Epsting Use oi Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building lype: _Single Fam�ily _Duplex Townhouse _Mulli-Family _Commercial <br /> Type of projecl: _New ,[Addilion _Remodel _Repatr_T.1. Sign_Sprinkler_Demdillon_Change of Use <br /> Description of Woric(addifional spece provided on fhe back): �,r E(,(� �� F4U� � �CJ l L b �uT <br /> W�Qs.S-�roow.s. TN- �S ING�Vi�C� U�pl�Tl►JCZ '-CItE. Ex�S7 � N�� <br /> � -� 2�oms . <br /> Have you aGAed vrorking without a pertnit? _YES �O <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> �(ypa of ProJsct: _New_Addn _Altar+tlon_Rspalr Typa of ProJ�ct: _Naw_Addn _AlbrNlon_Repdr <br /> SAowNumber �o/flrtuns Sl�owNumD�r MflxMes <br /> ! AIC-air handlin units I Toilet <br /> Forced air s stems I BaMtub <br /> Gas i in I Lavet wash basin <br /> � Waterheater I Shower <br /> I Gas fire lace I Kilchen sink&dis I <br /> � Gas ran e 2 I Dishwasher <br /> I Clothes d er I Clothes washer <br /> i I Ran o haod I Waler heater <br /> � Ezhaustian I Sink service/badm elc. <br /> Heat um � ���' �^�� <br /> Unit heater I Urinal <br /> I Boiler I Drinkin Fountain <br /> � Refri eretion I Floordrain <br /> I Woodslove I Greasetra <br /> I Duclin I Rooi drains <br /> � Other � Medical Gas <br /> SPRINKLER / SUPPRES810N SYSTEM I I Other. �V �,� <br /> �'� Number of Heads � Olher. <br /> I hereby certify thal I have read und ezamined Ihis applicaUon end knowtha sema to be We and correct.M Pravisbns ot laws aM ordinances goveming <br /> lhis type of Nork xill be complied v.ith Hhelher spedfied herein or not.Tho granling ol e portnil dons not paswne to give aulhoriry lo violete a cencei <br /> the pravision ol eny other stalo or local law rogulating construction a tho perlortna�ce of conslruction.That I am authaized by the owner of this property <br /> to Ihe v,orlc tor wfiich apdication is made and I complY Mlth the State Contractors Law 18.27 RCW and 296.200 WA� <br /> ����� - ��17-I/ <br /> OwnerlAuthorized pnnt5igneture Dale (Revised?/2071) <br />