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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINiCLERIDEMOLITION <br /> CITY OF FVERET7 PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425-257-8257 —www.evereltwa.org <br /> APPLICATICNS ARE ACCEPTED FROM 8 AM TO 4 PIA <br /> SITEADDRESS: -. � � PROPERTYTA%N �RMITR <br /> /r...; l i..a'� ,i i_ __ : > <br /> �'�S ��'G �l �- . , , ' <br /> LEGAL lor new constmclion: Short PlaUsubdivision Lol No._. (attr.ch copy of bn8 legal description) <br /> OWNER / ��a" !�+iC i� � " <br /> Fnonc/Email ��Z.S ` Z� `l � �� 6 Z' <br /> i <br /> Addmss -� '�'� I-t,_•' - �'-�c' Ci�ylStale/Zlp C 1.�•'-ic' r�-� L� �{- `J �Z` � � <br /> CONTRACTOR � ',. : i�.��`t�i�w� (^.,�t.,�.l �n�``�^� �'� L 8 I Lic.# CU ���'� �L � � ��'3 � <br /> �IY�� ' � �1/ Cr�cslt ij�,� Sk (��Z f�l;. 11 fY�c''� Phone/Email �fZS- 4hi - ZY�O C. <br /> Addross � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> T��, ; 1�< 5�.���< r�. C•., �Cr— � T. E .L� Phanc�E�man i—,.�� C:���nc(•�t-�•,�� ttc�. . Cn � �' <br /> BUILDING PERMIT APPLICATION CONTRACT PR�CE OF WORK 4� � ' `'� �'��C' m <br /> � <br /> Existing Use of Building `- '�f�,�� l CG�'i4'(— HEAT SOURCE: r1 <br /> � � •n <br /> Proposed Use of Building Gas_ Elearic_ Olher_ I <br /> Building lype: _Single Fan�ily _Duplex_Townhouse _Multi-Family _Commercial I�� <br /> Type of project: _New _Addition _Remodel ,'y Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> � <br /> OescriptionofWork(additionalspaceprovidedontheback): � ( . � +- L`{ SCcc. �<< I `'<'� � <br /> �-1,���rlj ' � 1'-'C �J ftC(i`���ll ..� <br /> ,.l " "� J <br /> ��.rk�n,� �..i•,�t �.12� k�n� f nSp�� �f t^iF � <br /> Have you started working withoul a pertnit7 _YES x. NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pro�ocL• _New_Audn _Altoration_ftepatr 7ype ol ProJact: _Naw_Addn _AlteraUon_Repalr <br /> Show Nunr6cr(M)of lixfures Show Num6er(NJ o/!lxtures <br /> � AIC-air handling units _ � Toilet <br /> � Forced air systems 8athtub <br /> � Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer � Clolhes washer <br /> Range hood \Nater heater <br /> Exhaust fan Sirk(servicelbarlmopletc.) <br /> Heat pump Back9ow preventer <br /> � Unit heater Urinal <br /> 6oiler � Drinking Fountain <br /> Refrigeration Floor drain <br /> Woods!ove � Grease Irap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM O�her: <br /> � Numher of Heads Other: <br /> I hereby certify Ihat I have read and examined Ihis application and kno�v Ihe same lo be Irue ard wrrecL Atl provisions of laws and ordinances goveming <br /> Ihis type of work will be complied�vith whether speciGed herein or noL Tho granling of a permit tloes not presume to give aulhonty to violale or cancel <br /> Ihe provision of any other s'ale or local law regulaling construcfion or the peAorm.nce af conslrvction.That I am authorized 6y:he owner ol this properly <br /> to pedorm the work for whioh application is made and I comply with Ihe Stale Coniractors Law 1027 RCW and 296200 WAC <br /> ��.����,�;� , , �. �_._�_ ,5Z-� � �� �� <br /> OwnedAtithodzedAyentSignature Date (Revised22077) ' � <br />