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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> S "1 —I <br /> SIT /�D RESS' . . PROPERN7AXp PE ITfF� <br /> F lh f( `� � . , �U � �� -��� <br /> LEGAL lor new constmclion: Short PIa1/su6division Lat No._ (altach copy of long Icgal description) <br /> OWNER ��cZ�L 'J Z-�� � 1'�✓��"t'� Phone/E�mail �,/ <br /> Address 7 ti ( C C I CitylState2ip (�� �� � T . <br /> APPLICANT: �vner Owner'sAgenl Conlractor Contractor'sAgenl _Tenanlfm�siProraeai�imro�mnsemrrommeownarmaowoMmm,saecal <br /> CONTRACTOR State Lic.# Cit Bus. Lic.# <br /> Address PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PFmne/E�mail <br /> BUILDING PERMIT APPLICATION coNTRACT PRICE OF WoaK 3(� -(�`� _ <br /> Existing Use of Building � �I� HEAT SOURCE: <br /> Proposed Use o(Buildin� Gas_ Electric_ Other_ <br /> Building type: _Single Family �Duplex_Townhouse _Mulli-Family _Commerciat <br /> Type ot project: _New _Addilion _Remodel _Repair_'.I._Sign_SFrinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back�: <br /> ,t�� c`; 2v�>;� -f- i�I=�2 �'l���c P�'�21 c'� o��� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoolProJoct: _Naw_Addn _Altaratlon_Repalr TypoolProJect: _Nuw_Addn _Altoration_Ropair <br /> Show Number(N)o!lia fures Show Number(tl)o/fixturcs <br /> AIC—air handling units I Toilet <br /> � Forced air systenu Bathtub <br /> Gas piping � Lavalory(wash basin) <br /> � Water heater Shower <br /> Gas fmplace � Kitchen sink&disposal <br /> � Gas range I Dishwasher <br /> ! Clothes dryer I Clothes washer <br /> Rdnge hood I Waler heater <br /> Exhaust fan ! Sink(service/bar/mop/etc.) <br /> � Heal pump I [3ackflow prevenler <br /> � Unit heater i Urinal <br /> � Boiler i Drinking Pountain <br /> � Re(rigeration � Floor drain <br /> Woodstove I Grease irap <br /> Oucling I ftoof drains <br /> � Olher I, Medical Gas <br /> SPRINKLER / Sl�`?PRESSION SYSTEM I Other: <br /> � Number of Heads � Other: <br /> I r.=icby<emly thot I have read and ennm�ned ihis apphcaLon antl know the samo to be irue ond cortect.All provisirns cl laws end ord�nances goveming Ihis rype ol�mrk wiil be comp6ed <br /> v.�;h v.�ether sp^cifed�ereln or not.T�e gmnting ol a permit tloes not presumo ro glve eut�ority lo violata or cancel tne pmvision ol any other slale or local law regvlating consVuction <br /> 7nnt I om authorized by IAe awner o1Mis p�oDerty to peNorm i�e�wrk!or x4ich oppi'^aUon Is matle anC I compy wd�tho Stete Contracton law 1B27 RCW an0 296100A WAC. 1/� <br /> 1 <br /> �� � � • � � �-�--�-�--.�L��13 <br /> OwnedAu ioriz�d Agon Stgnaturo Date (Revised 3Q013) <br />