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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/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 /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM 3 2C — I I <br /> PR PER P _�.�� <br /> �/�� ��/�"/�cIIT/L. <br /> LEGAL for new construction: Shor1 PlaVsu6division Lol No._ (atlach copy of long Iegal descriptian) <br /> OWNER Cj�{� SC�� ftl�'{� PhoneGmail <br /> Address � ') /2Ca. �'t j�R��14z CirylStatelZip <br /> CONTRACTOR �.L�1 �� � � G L&I Lic.# <br /> Address ,3J0� /2(.��(4wL. /7�-c��- PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> NG Phone/Email ,D/1t7 < - -" ZSZ) <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /,5K <br /> , .���-�� HEATSOURCE: <br /> Existing Use of Building 'e�'��--� <br /> Proposed Use o(Building IT�Il2G�IG� _ Gas_ Eiec�dc_ Other_ T�UN� <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _,Com�nercial <br /> Type of proJect: _New _Addition _Remodel _Repair�T.I._Sign_Sprinkler_Demolition_Changa ot Use <br /> DesCriplion of Work(addilional space provided on the back): <br /> Gc,,�(S17ZL�cT/c�.i G�z �.�c•v;� �/Lt�cro1� �-='`XZN Gt'(aC/Qtir�"i <br /> Have you started workiny without a permit? _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa of Projoct: _Now_Addn _Alteration_Rapalr Typo of ProJael: _New_Addn _Altoration_Repalr <br /> Show Number(Ml ol/ixmres Show Number(M)o/flxtures <br /> A/C-air handling uni�s Toilel <br /> Forced air syslems Bath�ub <br /> Gas piping _ Lavato (wash basin) <br /> Water heater � Shower <br /> Gas freplace Kitchen sink&disposal <br /> Gas range _ Dishwasher <br /> Clmhes dryer Clothes washer <br /> Ran e hood _ Water heater <br /> Exhaust(an Sink(service/bar/mop/etc.) <br /> Heat pump _ Backflow preventer <br /> Unit heater _ � Urinal <br /> I — Boiler — Drinking Fountain <br /> Refrigeralion Floor drein <br /> Woodstove Grease trap <br /> �uctmg Roof dreins <br /> Olher _ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM _. O�her <br /> NuntberolHeads — — <br /> I hemby cenify Ihat I have read and examined tliis application and know the same ta be Ime and wrtect.All provisions of laws and ordinances goveming <br /> ihis lypo of woik will Ue complied�vilh whelher specified herein or noL The granling ol a permil does nol presume to give aulhotiry to violate or cancel <br /> Ihe piovision ol any olher slate or local law regulating construction or Ihe periormance of conslrvclion.That I am authorized by Iha owner ol lhis property <br /> �o perlorm lhe work for which appticalion is mnde and I comply with Ihe Stale Canlraciors Law 1827 RCW and 296200 WAC <br /> �i ��-�._.- / 3 ! ' /! <br /> wnorlAuthodzod Agent Signaturo Date IRevised 12/10f0) <br /> '/Z <br />