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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICAT�ONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: Na0aea7vTAXa R T• _ ,0 . <br /> EJ�+cW \Ir . 4, 'p�100 <br /> 11 '1 '�pC.X1�C11 l <br /> LEGAL lor new construction: Shoit Pla"subtlivision__ Lot No.__ (allach copy ol long legal Oescription) <br /> OWNER �\i pl�p- FhonelE-mail �} ',S• l < ( <br /> Address � CitylSlalMZip �1k �.iA. Q <br /> CONTRACTOR L 8 I Lia # <br /> ��e ��4ka <br /> Address 3 '�j 1�b` AKC S �C PhonelEmail 9'Z�• '�I'�- II <br /> TENANT BUSINESS NAMF CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUIL�ING PERMIT APPLICATION coNTRACr PRICE oF woRrc ��FO00 <br /> Existing Use of Buildiny 5' ^1 FaMi�� _ HEAT SOURCE: <br /> Proposed Use ot Building�q�P �r'rv���- _�-- Gas_ Electnc _ Olher_ <br /> v <br /> Building ty�e:�Single Family _Duplex_Townhouse _Multi-Familv _Commercial <br /> Type of project: _New _Addilion �,Remodel �Repair_T.1. _�ign_Sprinkler_Demolition_Change of Use <br /> Descrip�ion of Work(addRional space provided on fhe back): <br /> Si�S� ��IC��6Cc� ���. ��"C. ��.SG �^�'1� �DCG� {'4�+n C`.O�NI j'O S�JbS . �RJt D�J O�� <br /> 1nJM1\Cd v�CGd G1�lVCal� "J1UTb�n� A�Z �CG.�C� °`^�. '�Q�"'�c.�. 0�� �'^d�"'� <br /> Have you started working without a permitT �YES _NO �„��� y��� ��.�,q� w�..t ov..) S <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATIQN <br /> Typo of?roJect: _New_Addn Alteration_Repair Typo of ProJect: _New_Addn ,Alteratian`�Ropalr <br /> Show Number(tt)ol/iztures Show Number(N)o/fixturcs <br /> A/C-air handling unils I Toilet <br /> Forced air systems � Bathlub <br /> � Gas piping I Lavatory(wash basin) <br /> � Waler heater I Shower <br /> Gas fueplace � � Kitchen sink&disposal <br /> Gas range � Dishwasher <br /> -` � Clothes dryer I Clolhes washer <br /> Range hood I Waler heater <br /> � � Exhaust fan Sink(service�bzdmop/etc.) <br /> I Heal pump j Backtlow prevenler <br /> I I Uml heater � Ur=nal <br /> Boiler Drinking Founlain <br /> Refrigeration Floor drain <br /> � � � Woodsiove Grease irap <br /> Dacting I Roof drains <br /> � Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> � Number of Heads I Olher. <br /> I hereby certify Ihat I have read anA examined this application and know Ihe same to he Irue and wned.All provisions of laws and ordinances goveming <br /> this lype of work viill 6e complied�vith whether specifietl herein or noL The granting ol a permil does not presume to give authority to violate or cancel <br /> the pwvision of a ,other slate or lowl law reguiating construclion or Ihe pedormance ol constmction.Thot I am aulhorized by Ihe owner of ihis property <br /> to peifor he v�rk f r whidi application is made and I comply�vith ihe Slate Contractors Law 1827 RCW and 296.Z00 WAC <br /> ' � �� <br /> Owned 'hodzad Agont Signaturo te (Revised 7/2077) l/� <br />