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2C; i10���1 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERtTT PERMIT SER�ICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: l PROPERTViA%p Pfi�JT�fIo _ <br /> �\ODL 5rc\P,�I�2 :�� 'I / <br /> LEGAL for new[orsVuc6on Shca PlaVsu04�v�s�on Lot No_ Iattach copy ol long legal tlesc�ipiion) <br /> OWNER L�l� Y �.� PhonelE-mail y c'�j ,j`,7 5 '\� � <br /> Aatlress �'C� � - Ciry/Slate/Zip C, Zv. <br /> CONTRACTOR ���� - > ` � �.L � I�-� , L 8 I Lit.# ` \�Yl . -_,� - L �� <br /> Atldress �a��� �> � ,� "'\ - � Phone/EmaA ZS - oC <br /> TENANT BUSINESS NAME CONTACT FOR PERMI <br /> C�9,r��ec�`n <br /> Phone/E�maJ <br /> BUILDING PERMIT APPLICATION coNrRACT PRicE oF woaK � <br /> Ex�sting Use of Building `-"�� HEAT SOURCE: <br /> Proposed Use ol Buildmg ��'�`���C����c�. Gas_ Eiectnc Otner_ <br /> Builtlingrype� �SingleFamily _Duplex_Tcwnhouse _Mulll-Family _Commerual <br /> Type of projecC �New _Addi6on _Remodel _Repair_T.I._Sign_Sprmkler_Demolifion_Change of Use <br /> Description ot Work(add�hona�space prov�tled on the back): , <br /> �-�ns�a\ ��e� �u�.�p, Ct�� �v�cy\��- � ��.v,c� ���.rk . <br /> Have you started working without a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ype of Project:�New_Addn _Alteration_Repair Typn of Project: _New_Addn _Alteratlo�_Repair <br /> Show Number(a)allixtures Show Number(r)olliamres <br /> AIC-air hantllm units Toilel <br /> Forced ar s stems � BathWb <br /> Gas pipin Lavato (wash 6asiN <br /> Waler heater 3hower <br /> Gas fireplace ' Kitchen sink 8 disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood � Waler heater <br /> ExhaUst fan � Sink(ServiCelbaflmopletC) <br /> Heat um 8ackflow reventer <br /> Umt heater Unnal <br /> Boiler ' Drmkin Founlain <br /> Refnqeralion Floor Crain <br /> Wo0d5tove Grease Uap <br /> Ductin Roof tlrains <br /> Olher � N�etlical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM ' Other: <br /> � Number cf Heads � Other <br /> I bereby cert�ry that I have read aiW eMam�netl Uis aDGlication antl Anow the same to be true antl wrrxl.All prov�sions of laws an0 oramances governing <br /> thi5 rype of�mrk w�ll De cOmp6ed w�ih HTelher 5peuheE herein or nol The grantmg ot a pertnM1 dces nel p�esume to grve au:honty Io violate or cancel <br /> ihe provision of any other state or local law regulaung constmGion or the pertortnance of wnstruc6on That I am authonzeG by�FP owner ol lhi5 property <br /> to pertorm t M�or� i appliwUon is made antl I comply�eth ihe Stat CoMraqors Law 1827 RCW and 296 200 WAC <br /> �(����-- �����! <br /> Ow�thorizy�Cgc t5ignaWrc �Cnte (Remse�2R077) <br />