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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everett a.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �- `''' � <br /> SITE AD RESS: / PROPERiY TAX N � P ��O _ <br /> Q l :.� /1✓e.i..z <br /> LEGAL for new conslruction: Short PlaUsubdivislon Lot No._ (attach wpy ol long Iegal descrlption) <br /> , � � '�o�n�..l ei ol•✓. a... <br /> OYVNER Phone/E-mall y � — �3�- �7 � <br /> ddress p . >y , ,� CitylSlalGZip ^ � i_r� `7 � � <br /> CONTRACTOR ,� �7/ L&I Lic.k <br /> ddrese PhonGEmail <br /> TENANT BUSINESS�AME CONTACT FOR PERMIT �Y�^ �•/ <br /> o r ,.+.. <br /> Phone/Email ' . �,. � i/a-. c -.— � .>> ' I - 5�"/� <br /> BUILDIN6 PERMIT APPLICATION coN7tucr PRiCEOF WORK <br /> F�cisting Use of Building � s'L�p '� H T SOURCE: <br /> Proposed Use of Qullding Gas � Electric Other <br /> Building type: l Single Family ,_Duplez_Townhouse _Mulll-Family ,_Commercial <br /> Typeoiprojecl: _New _Addi;ion _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change otUse <br /> Desuiptton of Work(addifional space provided on�he back): <br /> Have you started working without a permft7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJect: _New_Adtln _Alteratlon_Repair TypeotProJecL• _New,_Addn _AltanQon_Repair <br /> Show Number{MJ o/lt+tures Show Nam6ei(NJ ol Orfuree <br /> AIC-air handling unils Toilet <br /> � Fcrced air s stems 8alhtub <br /> Gas i in Lavato wash basin <br /> 1Vater heater Shower <br /> Gas fire lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clolhes d er Clothes washer <br /> Ran e hood Water heatc r <br /> Exhaust fan Sink servicalbar/mo letc. <br /> Heat um � BackFlow revenler <br /> Unit healer Urinal <br /> Boiler Drinkin Fcunlain <br /> Refri eralion Floordrain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM ( Olher: 1v�'{�Y ' r <br /> Number of Heads I Other: <br /> i hereby cetlif�that I havn read and ezamined Ihis appliwlion and know Ihe same to be tme and correct.All pmvisions ol laws and or0inances goveminp <br /> Ihis type of work will be complied wth whet�er specifietl herein or not.The grenling of a permil does not presume to y�.�aulhnnty to violate or wncel <br /> the provision ol any olher state or I w reBulating wnstruclion or lhe pertormance ol consWdion.That I am authodzed by Ihe owner ol thie properry <br /> lo perform Itx�rk i�vhi appl��tio �s made anE 1 compty wHh the Stata Contrector�Law 1827 RCW and 283.200 WAC <br /> OwnerlA�otl e�ifenl gna e / D te (Revised?/201f) <br /> L. <br />