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PERMIT APPLIrATION <br /> QUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROPERTYTAAII P6 T% �;— <br /> SITEADD�El$,S� .��� �. X ,S� }� I � (� ';��� <br /> `_' <br /> LEGAL lor ne�v constmction�, Shoit PlaVsul�division Lot No._ (atlach capy ol long legal eescription) <br /> � PhoneiEmail y S-35U • 1°i3 D <br /> OWNER S�C��t�- f-1�1�� OWIC21i� <br /> < L � C ��� <br /> Address � u��� � ��� � •, C— CitylStalelZip q� <br /> CONTRACTOR , . IC�II� � I��[l'� YL�I 171�5 L&I Lic.# l.l,`-Ia SI-//���L �1b I�(� <br /> Address,l4��� ,J, C'( Nto y'U� �7 � — C Q,V L2 C�� �.y PhonelEmail �-/� �-- 377-��//`� <br /> TENAN7 BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE�mail ��,�5-3�/7-/�/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK S D�l • �' <br /> —� HE/1T SOURCE: <br /> Ezisling Use of Building <br /> Proposed Use of Building . Gas_ Elecldc_ Other_ <br /> Building type ��Single Fai�iily _Duplex Townhouse _Multi-Family _Commercial <br /> Type�f projecl: _New _Addition !Remodel _Repair_ f.l._Sign_Spnnkler_Demolilion_Change o(Use <br /> Desc iplion of VJork(adtldiona�space proviCed on 1ho back/: <br /> �5.�{ 1� ��Ybj)G-'�t( -� ��'✓�"�-` - <br /> Have you started workfng without a permil? _YES NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProjoct: _New_Addn _Alteratlon_Repal! TypoofProJoct: _Now_Rddn _Allerotion_ftepalr <br /> Show Nunrber(M/o/lixtures Show Numbcr(N)ol lixfurcs <br /> � A/C—air handling units � Toilel <br /> Forced air systems Dathtub <br /> � Gas pipin Lavatory(wash basin) <br /> Water h,eater Shower <br /> Gas freplace Kitchen sink fi disposal <br /> Gas range Dishwasher <br /> Clothes dryer � Ctothes washer <br /> Range hood Water heater <br /> Eshaust fan Sink(service/barlmop/etc.) <br /> Heat pump I B�,;kflow preventer <br /> Uni�healer I Urinal <br /> 8oder I Dr!nking Founlain <br /> Refrig�ration Floor drain <br /> Woodstove � Grease trap <br /> � Ducling I R�of dmins <br /> Other_ �ledical Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM Jther: <br /> � Number of Heads I Othec <br /> I hereby cetlify Ihat I have read and examined this appliration and know Ihe same to be true and conecl.All provisions of laws and ordinances governing <br /> ihis type of work will 6e compiied with wheiher speci5ed herein or noL The granting ol a permit does not presume Io give authoriry lo violate or ca�cel <br /> Ihe provision ol any other slale or Iocal Imv regulaling conslruclion or Ihe pertormance ol construction.Thal I am aulhodzed Gy Ihe oxner ol Ihis property <br /> to pedorm Ihe wark lor r+hich applicalion is inade and l,comply with Ihe State Co Iractors Law 1827 RCW and 29u.2CJ WAC <br /> 1 <br /> L,��c��,�� �� ��ti ��'t1r t`�C� �i/�-1 �i <br /> Ownnr'.4uthodzed A�ent Bignaluro <br /> Da e (Revfsed7/1077) <br />