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i <br /> � ( <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERET7 NERMIT SERVICES <br /> 3207 Cedar St., Everett,WA 96201 -425-257-8810—FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: � PROPENT"TA%M PER ITM <br /> � �d � oaams- - <br /> LEGAL lor new construclon� SI-�q PlaUsubarvision lot No_ (allach copy ol lon9 legal tl�scnption) <br /> OWNER P� � q � O�aJ ' �r PhoneiGmail - — S' 'I <br /> Address G.. (�. Q (� C�ty�StalerZip � V <br /> CONTRACTOR � C f }�kf L&I Lic.# � AINoN� <br /> Atltlress �� a�+ � a� PhonelEmail 5/� � <br /> TENANT BUSINESS NAME ' 418 I/ CON7ACT FOR PERMIT <br /> S� � PhonNE-mad - - �/ <br /> BUILDING PERMIT APPLICATION cONianc7 Paice OF wORK �SD�J <br /> Existing Use of Building t�� HEAT SOURCE: <br /> PropoSed Use O(Building Gas_ Eiectnc� Olher_ <br /> Building type�. �Single FamJy _�uplex_Townhouse _Multi-Family _CommerGal <br /> Type of projecl: _New _Addilion �Remodel _Repair_T.I._Sign_Sprinkler_Oemolition_Change ot Use <br /> DeScription of Work(arl0dio�al space pmvitled on the oack)' <br /> Have you started warking without a permitT _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type af Project: _New_Atltln _l+Iteration_Repair Type ol Pm�ect: _New_Atltln _AlteraUon_Repalr <br /> Show Number(a)a/Iixfures Show Numher(M)a!/ir.tures <br /> � AIC-ahhandlin umts � Toilet <br /> Forced air s slems Balhtub <br /> I Gas pipino Lavato (wash basin) <br /> � Water heatef ' Showef <br /> �� Gas fireplace Kitchen sink S tlisposal <br /> � Gas ran e Dishwasher <br /> Clothes dryer Cbthes washer <br /> ' Ranae hood Water heater <br /> � Exhaust fan Sink(serviceibarlmo0�etc.) <br /> � Heat pump BackOow prevenler <br /> � Und hea�er � Urinal <br /> Boiler Dnnkin Fountain <br /> Refri erahon � Floor drain <br /> Woodstove Grease trap <br /> Duc6n Roof drains <br /> Other � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other <br /> Number of Heads � Other: <br /> I hereby cendy Inat I nave reaC and evamin�Ihis app'nCat:o�antl knew lhe same to�e Irue antl cortect.All provisions o��aHs and o�dinances poveming <br /> Ihis type of vrod e+ll be com0lied vnih wbether specdietl herein or not.The p�anling o�a{mrmit tices not presume ir.grvP aulhonty to violale or cance� <br /> Ihe prOvis�on o'3ny olher Slaie or IOcal law�2gul3�ir.g Con5INc0on or IM1e�1edOrmance ol Con5lrOCbon.Tl�a�I am 3U�hOnLCd by lhe Owner ol Ihis property <br /> IO pertorm ihe�wrk'Of wfiich aODliCatiOn is maae antl I wmply wnh t0e Siale ContraClOrs Law 18 2i RCW an0 29G 200 WAG <br /> / � ' J--� / 7/co/.20/� <br /> utl�orizetl Agent Slgnature J Nate IRevrsetl2R011) <br />