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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320D Cedar St., Everett, WA 98201 -425-257-8810-FAX 425-257-8857-www.everettwa.org'/ <br /> qpPLICATI0N5 ARE ACCEPTED FROM 8 AM TO 4 PM pp �p `—'-1 `� � <br /> PROPERiYTF%N �M�r,�� �� <br /> SITEA�DRESS: � „ �� �� .� i/ l.�p 95�: �9 ���"_�� d <br /> �i Kc W f� <br /> Lol No. (altach eopy ol long legal desuipiion) <br /> LEGAL for new construclion: Shorl Platlsubtlivislon — <br /> OWNER � . � � 5 D V Phonc/E�mail 4- c ' — <br /> ��ry�s���G��P �-Y/ W A � � � cc <br /> naa�o:s l_ o n � p T L o 5 G <br /> CONTRACTOR LI — " N G L 8'I rLic.# / <br /> Address � J � p y— "�".v _ ��-�Ya� r`eG�� P�onelEma oVJ �l ✓�� ' � �3 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail ���j � � — �� <br /> BUILDING PERMIT APPLICATION cONiw�c7 aRiCEOF WORK — <br /> Ezisting Use of Building SF2 <br /> HEAT SOURCE: <br /> Proposed Uso of Building S FQ Gas JS, Eleanc_ Other_ <br /> Buildingtype: SingleFamily _Duplez_Townhouse _Multi-Family _Commercial . <br /> Type ol projecl�New ,_Addition _Remodel _Repalr_T.I._Siqn_Sprinkler_Demolition_Change of Use <br /> Descrip�ion of Work(atldifional space provided on Ne back): 2-S�p�Y (,t)/G�(�W(� ,SP�r G <br /> N� �-�'��� <br /> Havo you started working withoul a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypaolProJecl: �New_Addn _�Ileratlon_Repalr TypoofPro�ee�: XNew_Addn _AlleraUan_Repair <br /> Show Numbcr(k)o!lixiums Show Nam6c�(pl o!Oztwc.^ <br /> � AIC—.irhandlingunits :y I Toile� <br /> � forcedairsystems � Bathlub <br /> � Gas pipin � Lavalo (wash basin) <br /> � YVater heater � Sho•�ver <br /> � Gas freplace I Kitch=n sink&disposal <br /> Oishwasher <br /> � Gasrange � Clotheswasher <br /> .� � Clo�hes dryer � Water heater <br /> � Range hood � Sink(servicel6admop/etcJ <br /> — Exhaust fan I <br /> Heat pump BackOow pre�en�er <br /> Unit healer <br /> Urinal <br /> Drinkin Fountain <br /> Boilef <br /> � Re(rigeralion FloorCrain <br /> � Woods�ovo � Grea;e lrep <br /> � Duclin � Roof drains <br /> � Other MedicalGas <br /> I SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> � Numher ol Heads � Olher: <br /> I here6y cerliy ihat I tavo read ond examined Ihis app'icalion and knmv l�a sama to�e We and wrrecl.All provisions ol la�.vs and ordiwnces goveming <br /> this rypa of x�ork wtll be compiied wrth whe�her speciGed herein or not.Tha granting ol a permit does nol p�esuma to give authon;y to violate or wncel <br /> Ihe pmvision ol any other stale or local la�v regutating mns�Nc�Nith tha St le Cont acecrs La v eC27 RCW`end 298.200 W\O��e o�rner of Ihis property <br /> lo peAorm tho�mrk lor e.4r.:h applicalion�s made a7 I cromply <br /> ,�,� �v ,. � � _ l 6 -- a � r a- <br /> p�� iRerseJ 71e017) <br /> wncr/Authadzed A9ent Signaluro <br /> �/Z <br />