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PERMIT APPLICATION <br /> BUI LDINGIMECHANICAUPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES 6 -a i-i z <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> P0.0PERT'TA%M RMIT# <br /> SITEADDRESS: (� , � bU i 1 �� � U�� �� �� �y l <br /> ` " AUL ' uC I :'1� � <br /> LEGAL for new consWcticn: ShoA PlaUsubtlivision Lol No._ (altach rnpy ol long legal descnption) <br /> OWNER �, � ( �"1� PhonrJE�mail <br /> � <br /> CitylSlate2ip <br /> Address ���(� V'C, <br /> CONTRACTOR NG'(��.l2. f a' L 81 Lic.# Ivor?�w.�. !`'�t <br /> ^r� ,jt �• �.(� � ' PhonelEmail �a,� -� - 3 <br /> Atldress �� ,y.�,� ` �w '�A`n��, �U'YGC <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT�oG Z.Mt`�V' <br /> Phone/E�mail j ''�,�0� <br /> BUILDING PERMIT APPIICATION CONTRACTPRICEOFWORK IO <br /> Existing Use of Ouilding <br /> S1A((�l�-`- �4MI�Y I��SIO�N� HEATSOURCE: <br /> Proposed Use of Duilding S�� Gas_ Elecinc_ Olher_ <br /> Buildingtype: �SingleFam�y _Duplex_Townhouse _Multl-Family _Commercial <br /> Typeofprqect: _New �,_,Addition _Remodel _Repair_T.1._Sign_Sprinkler_Demoiilion_Change oNse <br /> DeScfiplionolWork(adtlitionalspaceprovidetlontheback): ipSk�` �O/� �G0.� ���� �h+�'�L LnL�U+4�` <br /> �'c.���i. tn t_,<iJC��+�,, t[,"cKlC., ,S�t�� <br /> J <br /> Have you slarted working without a permit� _,YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Ty o1ProJecL• _New_Addn _Alterntlon_Repalr Typ ofProJect: _New_Addn _Alleration_Repalr <br /> Show Numbcr(p)ol flatures Show Nuv6er(Yf o!fldwes <br /> NC-air handling units Tcilet <br /> \ � forcedairsyslems I Bathlub <br /> Gas pipin Lavato (wash basin <br /> I W:,ter heater � Shower <br /> ' itchen sink 8 sposal <br /> � `Gas fireplace Di washe <br /> Ga ange I <br /> � Cblhe�, er Clolh asher <br /> � Ran e ho I Wat r, er <br /> [xhavst an \ � 5 (servic admo /etc.) <br /> Heat¢ump � ackllow reve er <br /> it heater I Urinal <br /> i oiler Orinkin Fountain <br /> '� Refri eration Floordrain <br /> / Woodslove \ � Grease lra <br /> i� Duclin <br /> Roof drains <br /> ' � Olher Aledical Gas <br /> SP�tINKLER I SUPPRESSION SYSTEM I otner: <br /> � Number ol Heads � Olher: <br /> I he�ebVi certiy Ihat I havo read anA examined ihis applica�ion and knmv t�e same to be tme antl correcL All provisiuns ol�aws antl ordinances goveining <br /> this type ol work will be comDlied t•+ith whether specife0 hereln or nol.Tho granting of a permd does not presume to give auNoily to violate or wncel <br /> Ihe pmvision ol any olher stale or lowl law reBulaling consimction or the pedo�mance ol constfuction.Thal I am euthorizetl by the owner of thls properry <br /> to p^_dorm iha�wrk lor wh¢tl�pPl�tio�made and I comply with Ihe Stale Conlraclers Law 1017 RCW antl 29B.200 WAC <br /> .� � �'��' � (`- � <br /> �\ " �._il' l� <br /> OwnedAuModzed Agent Signaturo <br /> Oate (Revised711011i � 7j <br /> // <br /> 1�, <br />