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PERMIT APPLI�CATION <br /> BUILDINGIMECHANICAL/PLUMCiINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES a �-� —/Z <br /> 3200 Cedar St , Everett, WA 98201 -425-257-8810-PAX 425-257-8657-vrvrw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROIA 8 AM TO 4 PM �� �UZ'U <br /> PflOPEftTYTAXp PER 11 a <br /> SITE ADDRESS: `��i j J � �- C� �'-�� <br /> 1 , r �Zu�K�c' c `_ <br /> LEGAL for new mnslmcYoti Short Plotlsubdivision _Lol No._ (attacn copy cl long Icgal descnplion) <br /> OWNER I\A��• '1" S�� 1�. f'� Phone�[-mal r7Z(�fi - 3 t•5 - ��.3-�_� <br /> AV CIIVIStale2�P �J C��, 4 C �Z� <br /> Address �.� � ..Z(� �� !_� }� _� <br /> CONTRACTOR �� ^ �U . L&I Lit'./# I )L'�-F'C�(/1 • �J <br /> Fdtlms5�3 ' S I 3 ������ �N :(G �`'.( ( �/F' " P�cnelEmail ��� �3- E �� - <br /> TENANT BUSINESS NAME � CONTACT FOR PERMIT � ,�/_ _ -7�{�_ ��/ � <br /> ' lC' l { �{< <br /> Phone�E-mail � � �. � U��"iSU� �'�L15 '�� kif� �%i .^'` <br /> BUILDINGPERMITAPPLICATION CONTRACTPRICEOFWORK ! <br /> Exisling Use ol6uiliing HEi\T SOURCE: <br /> Pmposad Use of Building Gas x Electnc_ Omer_ <br /> Buildingl;pe: _SingleFamily �Duplex_Tovrnhouse _M19ulti-Family _Commercial <br /> Type of project: _New _Addition _Remodel �Repair_T.I._Sign_Sprinkler_Demolition_Change of Use � <br /> DeSeription of Work(addifional space F�o�itled on:,�e back): <br /> �;«. a�.,�,�,�r ��P«,�-_ �l�c n��o onl�� �al� �n�eF�� , <br /> HavcyousWAcdwcrkin�withoutapermit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeafPmJecl: _Nmv_Addn _Allerallon�,Repalr TypoofPro�ect: _New,_Atldn _Ntera�lon Repai� <br /> Show Numbe�(kJ af/ir(ures Show Numbcr(C)olllYiurcs <br /> � NC-airhandlingunits I Toilel <br /> � Forced air syslems I Bathtub <br /> � Gas piping I Lavatory(wash 6asin) <br /> � Water healer I Shmver <br /> � Gas fireplace � Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> � Clothes drycr � Clothes u�asher <br /> � Range hocd I Water heater <br /> Ezhausl fan � Sink(servicelbadmopietc.) <br /> Heal pump I Bockfiow preventer <br /> � Unit heater I Urinal <br /> Boiler Drinkin Fountain <br /> ( Refrigcration � Floordrain <br /> � Woodstove � Grease trap <br /> � Ouctin9 Roaf drains <br /> � Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> INumber of Heads I Othec <br /> I here6y certity that I have reatl and eaam'�ned Ilus application and Ano�.v I�e same lo Ce Ime and mrrect.All pmvisions ol�a�vs ana o�tlinances goeemlrg <br /> ihis typo ol wo�k wAI be eomplied x+th w�elher speciGed herein or noL TTe gra^ting ot a Fermd does not presume to give autneNy lo�ioiate cr cancel <br /> �he Frovision ol any olher stale or local law rcgulating consl�uction or tho pedortnance ol crnslruction.lhat I am authorized 6y R�e ce:ner ct t���s prsperty <br /> tu pedor the wark lor which app��ion is matle an�mply��ith the Slale Conlracicn�a�v 19 27 RCW and 296 200 V'AC <br /> =� «--� �y�cs ar��.Z <br /> �/tlwn flA Iliodfo A9enl Sl9wture �dle (, evi:ed7/1017) <br /> �� i <br />