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� � � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, W A 98201 -425-757-F3810—FAY. 425-257-8857 —v,nvw evcrettwa.org /` <br /> APPIICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/ �Q(/�/y <br /> SITEADDRES���� � PROPERTYTN(p P[RMIT – <br /> LEGAL lor new�„r,�,imclion: ShoC Plallsubaivision Lct No._ (ai�ach copy cf long legal descriplion) <br /> OWNER PhonME�mail �{Zj �jt"j_C�SC� <br /> �dd«ss �6 5' Nu v = �,�Y�s�,���z�o C�� - �203 <br /> CONTRACTOR C'V' ' � L& I Lic.N L(/., <br /> nadrr s ( Gi ( G I'honei[mari �{ s <br /> TENANT BUSINESS NAME CONTqCJ FOR Pf�.-�Q_MIT � � <br /> K�.,u �9 <br /> Pha���t-ma�� 5��52-3/i <br /> BUILDING PERMIT APoUCATION CONTRACT PR:'. :OF WORK Q,'YJ � � <br /> Existing Use of Building_ _ HEAT SOURCE: <br /> —� <br /> Propesed Use oi 6uiltlin� Gas [lectr�c Olner <br /> �wlding rype: ,�Single Family _Duplex_Townhouse tdWli-Family _Commercial <br /> Type of prejecC _New _,Addition __Remodel _Repait�T.l._Sign_Sprinklr,r_ _ DemoliUcn___Change of Use <br /> DCSGrip�iono(Work(add�GonalspacopiovidedonlhobackJ: � � <br /> ��- b��e� I� � �S�. <br /> Have you started working wilhout a permit? __YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project IJew__AAdn ❑crnllon_Repalr Type of Projecl: ___Ncw_Addn _Allc�atlon_Repair <br /> SlrowNurnber(p) /lirlures SbowNumher(N)n/flrtures <br /> A/C—air handling units Toilet <br /> Porc.ed oir sys�ems C�athfub <br /> Gas pipmq Lavalory(wash basin) <br /> W�llcn c�alcr Shorvcr <br /> Gi;fire late Kqr,hrn�ank R dis�osnl <br /> Gas ronqo Dishw[ishr.r <br /> Ciolhes d cr Golhr.;w.ishcr <br /> f2ange hond Wuter hn��lcr <br /> Er�haus�fan Sink scrvicc/badmo /r,lr.. <br /> I IHnI pump Becklirnv prr,vr.nfcr <br /> � Und hcatcr Uiin;�l <br /> Bo�ter Unnkmq Founlain <br /> Refri eration Floor dr�in <br /> Wnnd;tovc Grc�tie Irap <br /> Uur.tin Roo(drains <br /> Other MeCir.al Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Numbcro(flcads I Olher <br /> I hereby ccrLly ih�t I have rcad and examincd Ihis apPlicalron anA know Ihe same lo be Iruc and wrrcr.t.All pwvi,iuns of Iaws and oMlnances�ovrrn�nq <br /> Ihi;lypr.ol urnk w I be cmnpl;ed w ier speulir,d herein or nnl.iho granlmg of a permil does not presume lo give authonty Io violale or cancet <br /> Ihe provis� ol ry olher:late lor,al law egulating r.onslruG��on or Ihe perlormance ol consUuclion.Thal I am aulhonzed Ly Ihe owner a(Ihis propi:�:ly <br /> lo pedmm t io ork for whl�.h: plicatlon'.rn; u and I comply�alh Ihc Slatc Cnnlraqors�nw 1(127 RCW and 79fi 900 WAC <br /> l V �7i�'� <br /> Owncrinulhori:ed nqenl Si9na�u�c oalc (Rev;tnd J/7n77J <br />