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rERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLI�ION <br /> CITY OF EVGRETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 93201 -425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM '2 _Z ��� <br /> PRUPENTYTA%N P RMIT%D <br /> : 03o G�LAU/' � � � - �o <br /> LEGAL lor new construclion: Shotl Plalls���iivision Lel No._ (atlach copy of long Iegal descrip!ion) <br /> /au6,a�ci��`�'/i� <br /> OWNER L � ��C'L�. � � Phone/E�mail S-3� - � � " ' <br /> Address � '� ) (f��-�L/�� V CirylStalelZip . ;�` i - <br /> CONTRACTOR .t�� L 81 Lic.# <br /> Phone/Email <br /> Address <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> HEATSOURCE: <br /> Gxisling Use o(Duilding <br /> Proposed Use of Building Gas_ Eiectnc_ Other_ <br /> Building type: ?�Single Family _Duplex_Townhouse _Multi-family __Commercial <br /> Type of proJect: _New _Addition _Remodel _Repair_T.I._Sign_Sprinklcr_Demolition_Cl�ange ot Use <br /> Description of Work(adddional space prov�deAon Ihe back): 1 <br /> L «� ��,E -�, ,C�, /.� <br /> Have you slarted working without a permit? _YES _NO <br /> MECHANICAL PERMIT APPLICATIUN PLUMBING PERMIT APPLICATION <br /> Typoof ProJect: _New_Addn Alloration_Ropair TypoolProJect: _Naw_Addn _Aiteretlon_Repalr <br /> Show Numbcr(N)ollixfures Show Num6cr(R)of lixtures <br /> � AIC–air handling umts _ ; Toilei <br /> Forced air systems _ Bathlub <br /> Gas pioing _ Lavato (wash basin) <br /> Water heafer � Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range __ Dish�,vasher <br /> � Clothes dryer __ � Cbthes washer <br />–. — � Water heater <br /> Rangehood — <br /> Exhaust fan Sink(service/badmopletc.) <br /> Heat pump Backflow preventer <br /> � Unil heater _ Urinal <br /> — � Boiler _ �rinking Fountain <br /> Relrigeralion Floor drain <br /> Woodstove _ I Grease lrap <br /> Ouchng _ Rooidrams <br /> � � �ihe� L _ _ Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM _ Other <br /> Number ol Heads — <br /> I hcie6y certify thal I have read and eramined thla aopl�ralion and know the same to be Irue and wrrecl All pmvisions ol laws and ordinances 7oveming <br /> this typu ol work will be complied with whether speo;�eA here�n or noL The granting ol a permit does nol presume to pive authority to violale or cancel <br /> il�.e provlsicn of�y other slalo or local law regulatin�wnstruition or Ihe pedormance of constructioa That I am authorized 6y the owner ol this property <br /> io peitorm�th�e��'5rk lor which ap �, on is atle anu I comply with the State Coniractors Law 1827 RCW and 2962�0�7AC <br /> � if./�� - ��� a�z�i i <br /> a�� lRev,setl 7.'Q010) <br /> OwnedAuthorized Agent Si��4i'ure - <br />