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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—wwYv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS:�� �'�� PROP¢�TAxa t ` .O P I p� ,�D 7 <br /> LEGAL for ne5v constaK;ion: SMrt PlaUsutbivision Lot No_ (�flach copy of long Iepal tle=aiption) <br /> OWNER G(IlGL/�j�r � O Phone/E�mail y�5-35,� J� <br /> -�/ p � ' <br /> Address %/(,� (i(/ j% ���. C4ylSta:e2ip C�/�7lLF'T'T �' <br /> CONTRACTOR ' )1 � L&I Lic.* � � /'J -/ � rC- <br /> AdCre55 . � �� � N/J n-� �S Phone/Email �/- 7 /S�� �(!' <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT C2:,'J� I �AVCL{'-/' <br /> ! 7� 7 N <br /> Phone/E�mzil j f� + � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK < <U <br /> Exisling Use of 6vilding HEAT SOURCE: <br /> Proposed Us=ort�B/u,�ilding Gas � Eiectric_ Other <br /> 8uiidinglype: y�vingleFamily _Duplex_Tovmhouse _MWti-Family _Commercial <br /> Typec'project: _New _Addi;ion _Remodel Repair_T.I._Sign_Sprinkler_Demolilion_ChanQe ofUse <br /> De3Cription O}WOtk(adtlifionaispaceprovidedon fhe bacY,); ��P(�G�C �K(J���� (�14 r7 /!Lf�1�i{'Cf!� W�n-� <br /> ` A�✓t�c� (�'R5 �T/�ni�tc� .�N TIfESqy,1� Lac�n�,•nl� /�1D �Uc'C� GAS <br /> I�fV�N 6� �1�n a,�s7.t�� � n/r'c� N��c r Pc IOh P. <br /> Have you started working without a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeotPrejcct: _New_Addn Alteration_Repair TypeofProJeel: _Ncw_Addn _AltereUon_Repair <br /> Shmv Num6er(«)o!/ixfures Show Number(R')of Iixtures <br /> WC—airhandlinounits � Toilet <br /> � Forcedairsyslems � ��thtub <br /> � Gas pipino � Lavato (wash basin) <br /> � WatErheater Shower <br /> � Gas Lreplace Kitchen sink�disposai <br /> Gzs ranae � Di�hwasher <br /> Clothes dry�er � Clo,hes washer <br /> � Ranae hood I W=ter heater ' <br /> � Exhzust fan Sink(servicePoadmopleic.) <br /> Heatpump � O�ckflow revenler <br /> Unit he�t=_r Urinal <br /> � Boiler I Drink�no�ountain <br /> � Re`riaeration Floordrain <br /> � Wocdstove Grease trap <br /> � Ductina � Roof drains <br /> � O,her Medical Gas <br /> SPRIMKLER I SUPPRF.SSION SYSTEM O;her. <br /> � Number ol Heads Other: <br /> I heeby certiry thzl I have read arM e�mined this epplicalion and know the szme to be We antl correct NI provisions ollaws end ordinsnces Qovemirig <br /> th-�, rype oi work vAll be wmplied wiN whether apecifed herein or not The granling of a pertnit dces not presume to pive eutMrity to violate or wncel <br /> the prwision ot any other s:ate or local law repulating consttic,ion or the pedortnance o'consWc6on.Thal I em euthorize�by Ne ovmer ot lhls property <br /> to peAo t(�aw9rk forwhlch appli -�n is d n ly vnth�he 5 e C ntractors Law 1fi27 RCW and 286200 WAC <br /> Owne�^edAgentSign� � D te � (RevisedY2071) <br />