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� ��a - �i5�i' �z . �� <br /> Ec-'r�ze,'� c�itl �i8�c��(. <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBING/SIGN/SPRINKLER/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 /> / � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM p ;;p;/ �l. r�-u r cI_ � l:�r� �- <br /> SITE ADDR�S: PR �D O vp UOD Q�/O(,7' PERI�FT`IID <br /> .�l 6 f<r o�r l� <br /> LEGAL lor new construction: Short PlaVsubtlivision SS {1 C!� - O�I Lol No. (a��ach copy af long legal description) <br /> OWNER �-�" � � /�: � � � L (,( Phone/Email <�S p 7`7 - �77 dC V I Ll.�.�iVS� n� <br /> Address �`' � CitylSla�elZip 5(r� (/�l I S L�� � �� <br /> CONTRACTOR ,I,JVI�� L&I Lic.# <br /> Address jQ�7Z(� PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail ',�'J!✓ 9-9��0 vr�co � ��� �l��• <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3.�I (�0.2. ��� <br /> Existing Use of Building 1 HEAT SOURCE: <br /> Proposed Use of Building 3 a �o �� FFI- S F2. Ga Electric_ Other_ <br /> Building type: �Single Family _Duplex_Townhouse _Multi•Famiiy _Commercial <br /> Type of project: �New _Addilion _Remodel _Repair_T.I.__Sign_Sprinkler_Demolition_Change of Use <br /> Desttiption of Wofk(addilional spaceprovided on fhe 6ack): ���� ��M����aCn�� / ' J <br /> �tJe�� llo�se �,�;�1, a�fach �G2�i�� yoa uti�.` ����� ' <br /> Have you started working without a permit7 _YES _NO /0 y(p ��-a-s e- �� 7�`� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProJect: 1Now_Addn _Altaratlon_Repair TypeofProJect: _New_Addn _Altaretlon_Repair <br /> Show Number(M)o/Iixfures Show Number(NJ ol fixfures <br /> A/C-airhandlingunits � Toilet � <br /> Forced air s stems I 8athtub <br /> � Gas piping I Lavato (wash basin) <br /> Water heater Shower <br /> -�' � Gas�replace Kitchen sink disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes wa�i�er <br /> � Ran e hood � Wa�cr i�ealer <br /> j�. Exhaust fan � Sink(servicelbar/mopletc.) �n d,1 <br /> Heat pump � Backflow prevenler <br /> Unit heater l�rinal <br /> Boiler Drinkin �ounlain <br /> Refri erelion Floordrain <br /> - � Woodstove Grease trap _ <br /> � Ducting Roofdrains <br /> Other Mediral Gas _ <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number of Heads I Other: <br /> I hereby ceAify tha�I have read and examined�his applicalion and know Ihe same to be Irue and cortect.All provisions ol laws and ordinances goveming <br /> Ihis lypo of work will be complied with whelher specifed herein or not.Tho granling of a permil Coes nol presume to give authority ta violate or cancel <br /> Ihe provisinn ol any olher slale or loca�law regulaling conslruction or ihe peAormance ol conslruction.That I am aulhorized by lhe owner of this property <br /> lo perform thework forwhich application is made and I comyp�wilh the �ale Contractors Law 18.27 RCW and 298.200 WAC <br /> �� �uX �X/�'J�T// ti <br /> Oyln rlAut orizod Agont Signaturo i Date (Revised 2/2017) I� <br /> � <br />