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PERMIT AI'PLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA�J8201 -425-257-8810-FAX 425-257-8857-v�nvw.everettwa.org <br /> APPLICATION5 ARE ACCEPTED FROM B AM TO 4 PM 3 �-% `I� <br /> SITE ADDRESS� _ PROPF.RN TA%N PERMIT <br /> n <br /> ' Cl' �� � �� . � ��R'-� •v <br /> LEGAL lor new construction: Short PIaV.u6division _Lot No._._ (atlach copy ol long legal description) <br /> OWNER� � n��S iS���w�U(�1�� iCC I ves5� PhonelE-mail y�Z�s'�J�-��LI ��m.�z�S�ik.7�J �'mur �. Con� <br /> Address .-'�(j� �i l�r ;� ,pn � JY . ��'%'�{�� City/Statc/Zip CVe/'G� !C)�1 ���.209 <br /> i <br /> CONTRACTOR < z/C�a`nc'v L 8 I Lic.# <br /> Address Phane�Email <br /> TENANT BUSINESS NAME CONTAI:T FOR PERMIT <br /> PhonelE�mail <br /> BUILDING PERMIT APPLICATION CONTrzACT PRtce oF woRK 1-.SLY� � <br /> Existing Use of Building�'C'S <« �� ��— HEAT SOURCE: <br /> ProposedUseofBuilding /�"�;c�r'r<<c- Gas '� Eledric_ Other_ <br /> Building type: �Single Family __Duplex_Town'iouse _Multi-Family _Commer�ial <br /> Type of project: _New _Ad�'�.ion �Cl�emodd _Repair_T.I._Sign_Sprinkler_Demoli�ion_Change of Use <br /> DeScriplion of Work(adddional space pmvided on Ihe ba:k): <br /> �'�1QtIqC' ��nJ(� �J[i�llrCO�r �� /l9c�S�cr'd ��C�c)CIC.� ��zr.��. <br /> J <br /> Have you s�arted working wilhoul a pernilt7 _YES _NC <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJacl: _Now_Addn _Alteratlon_Ropair 7ypn of ProJect: _Nuw_Addn l<Alterelion_Repair <br /> Show NumGcr(q)o!Iixtures :f�ow Numbcr(N)ol Iixtures <br /> A/C—air handling units I Toilet <br /> � Forced air syslems " BatMub <br /> Gas piping .2 I Lavatory(wash basin) <br /> � Water heater Shower <br /> � Gas fireplace � Kitchen sink 8 disposal <br /> � Gas range � Dish�vasher <br /> � Clothes dryer / � Clothes�vasher <br /> � Range hcod I Water haater <br /> 6xhausl fan � Sink(service/bar/mop/elc.) <br /> Heat pump I BackOow prever.ter <br /> � Unit healer � Urinal <br /> [3oiler � Drinking Fountain <br /> Refrigeration Floor drain <br /> � Woodslove � Grease Uap <br /> i Ducting I Roof drains <br /> � Other_ Medical Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM I Other: <br /> � Number of Heads I Olher: <br /> I he,e�y certify Ihal I have read and ezamined ihis applicallon and know the same to be Irue and co«ec� All provisions ol laws acd ortlinances qoverning <br /> this iype of work will�e complied with whelher specifed harein or rol.The granting of a permit does nol presume to give aulhonty to violate cr cancel <br /> the p,ov�sion of any olher slate or local law regulating constmc�ion o�Ihe pertormanco ol consimction.That I am aulhorized hy the owner of ihis property <br /> tr,pe�t;.-�n the work lor which application is made and 1 comply with ihe S�ale Contractors Law iB.27 RCVJ and 296200 WAC <br /> � . <br /> i _ , `.- , - ,'� �� ; �- �I <br /> OwnedAulhodzod Agont SlgnaWrc Dalc (ReviseJ 2/1071) <br />