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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SF'FtINKLERIDEMOLITION <br /> CITY OP EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereit, WA 98201 -425-257-8810-FAX 425-257•8857-wvaw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G — <br /> SITEADDRESS: .�- PPOPERT'TAXH P ITt <br /> ' 3 i vLr��. .LP �I I�(� -01(� <br /> LEGAL for�ew construction: Shon PlaVsuotl�vision lot No._ (attach wpy ol long iegal tlescription) <br /> OWNER � [,�v iV ' rF� J 13{� - \IC � r'honci6mail �fZs - �'/Q3 -5// ` <br /> Address a�( �j ' ) A(,S G City/StatMZip ��/L (�ZL'� <br /> CONTRACTOR ��V�1-.n c�- �l` L81Lic.# ���IFQ-F�C_(.. y4CZ <br /> AdUress ( �j j�j�� jj0�.(C. ��V�L Phone/Email y2j -��(p� yj <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> P�one/E�mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE oF WORK �GGGOCJ <br /> Existing Use ol8uliding _ HEAT SOURCE: <br /> Proposed Use of Duilding Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.i. _Sian_Sprinkler_Demolition_Change of Use <br /> Description of Work(addi;irnal spato provided on Iho beckJ: <br /> jLc Lo�_.,i ; �.-�� O/" c.:�4� /�.c-�cr/L <br /> Have you started worktnc�wilhoul a permit? _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo at Projact: _Now_Addn _Altoratlon_Rapair Typo ol ProJoct: _Now_Adtln _Altoratlon_Ropalr <br /> Show Num6rr(a)ot lixtures Show Number(pJ ol nxturcs <br /> � AIC-airhandlingunits Toile� <br /> � Forced air s stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> � Watcr healcr I ShoH•er <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Rangc hood Waler heater <br /> Eshaust fan Sink(service/bar/mop/etc.) <br /> Neal pump � Backflow preventer <br /> � Unit heater Urinal <br /> I Boiler OrinKin Fountafn <br /> � Refrigeration Floor drain <br /> � Woodstove Grease irap <br /> Ductin Roof drains <br /> � Other Medical Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM Other: <br /> � Number of Heads I Other. <br /> I hereby ceitify Ihai I have read and examined Ihis app�icallon,nd know lhe samo to be tme and correcl.Ail provisions of laws and ordinances goveroing <br /> Ihis type ol work will be complied with whethr.r specifed herein or not.Tho qranling of a permil tloes not presume lo give aulhonry to violate or cancel <br /> Ihe provision ol any olher slale or local Imv regulating conslmctlon or Ihe pertomiance ol conslmclion.That 1 am aulhorized by��e owner ol ihis property <br /> to perbrm Ihu work lor�vhich�pplicalion is ntada and I comply wilh Ihe Sta�e Conlractors Law 1827 RCW and 296200 WAC <br /> i' / ( <br /> ��� ���- . /.. . l.d i), �/ <br /> j'..�y . <br /> OH� Authodzod Agent Slgnaturo Dale (Revised Z/1011J <br />