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� PERMIT i4PPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGlSIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERET' �ERMIT SERVICES <br /> 3200 Cedar Sl., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SIT_ ADDRESS:. � PROPERTYTAXN PERMITk <br /> / � � <br /> ,t'� iri��'� �`f � 00; 31a00 . �. � o -O/ <br /> LEGAL lor ne�v construction: ShoP plaVsubdivision__________—____----�ol No.____ (attach copy of long legal description) <br /> OWNER J �111fJ 1 t J/ /�1 Phone/E•mail � 7 (/�,.�i � � � +'t <br /> � � � ��� , m <br /> Address ' �! '� �n I 'l IP� �� CitylSlalelZip J , <br /> CONTRACTOR /1� [ ��1 f n� L 8 I Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> P�onelE-mail (�'p- `�90�3��p JU�(Y�QStC �/l� M- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ---- <br /> Existing Use of Building_� �=� ��� � ' � HEAT SOURCE: <br /> Proposed Uae o(Building_./�_"= �'�' ' ''� �_ Gas____ Electric_L__ Other___ <br /> Buiiding type: T!Single Family __Duplex_Townhouse __Mulli-Family _Commercial <br /> Type o(project: __New _Addition _�Remodei _Repair__T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Desc�iption o(Work(adtlilional spaca provitled on�"e back�: <br /> L� `.V �.J �, � (!'U_'il� 4� �E F',�( irl.J , <br /> Have you started workir.g without a pertnit? �YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ot ProJect: __ New__ Addn __ Alteratbn�Repair TyFe of ProJecL• _Naw__Addn _ Altaration .__Repalr <br /> Show NumDer(MJ o/�xfure: Show Number(X of firfures <br /> n � A/C-air Y.andlin units / I Toilet <br /> I Forced air s stems I BathWb <br /> Gas pi in Lavalo wash basin <br /> �� Waterhealer I Shower <br /> r � Gas fireplace / I Kdchen sink 8 dis osal <br /> (! Gas ran e I Dishwasher <br /> ' Clothes d er I Clothes washer <br /> �� Ran e hood I Water heater <br /> � Exhaust fan I Sink service/barlmo letc� <br /> i � Heat um Backllow reventer <br /> � � Unit heater I Urinal <br /> /) I Boiler (J Drinkin Fountain <br /> (� Refrigeration Floor drain <br /> ' Woodstove Grease Ua <br /> � Ductin I Root drains <br /> Other____________ _. Q Medicat Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads I Other: <br /> I hereby cetli(y Ihat I have read and e,eaminod Ihis application and know iha same lo be Irue antl cortecl.All provisions of Isws anA ordmances goveming <br /> Ihis type ol work will be complied wilh whether specified herein or nol.The granling ol a permit daes nol presume to givr.authonty to violate or wncel <br /> Ihe provision o(any olher slale or local law regulaling cons�ruclion or�he peAormance of conslruclion.Tha�I am authorized by the owner af Ihis property <br /> lo perlorm ihe work lor which application is made and I roinply wilh Ihe S�ate Conlraclors Law 18.27 RCW and 296.200 WAC <br /> u.,�,��;�� c�- 9��1 <br /> erlAuthorized Agenl IgnaTure Dale (Revisod 2/2011) <br /> �la <br />