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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES y -a�--r�— <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.arg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM <br /> SIaApDR SS: PROPER T41f T`M�� ' <br /> � 1 �j <br /> LEGAL for new const�udion: ShoA PlaUsubtlivision Lot No._ (a1taU copy ol iag lepal OescAplbn) <br /> OVYNER � � PhonelE•mail <br /> tldresn � 7 �LQ� CitylSlate/Zip a, bl <br /> coNrrincro L&I LIc.N TIZ r �inJ G 7�a KO <br /> dtlres� �� � , ;J Phone/Email yo1S JU � d I <br /> TENANT BUSINESS NAME COi�CT O�5R(,PE�MIT <br /> P�one/ �mail " _ ( <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE oF woRK 0 <br /> Ezisting Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gaa Electric Other <br /> Building rype: _Single Family _Duplez_Townhousa _MuNi-Family _Commerctal <br /> Typa of projed: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler Demolitio Chenge of Use <br /> Desaiptlon of Worlc(addi(ional space provided on fhe back): <br /> IZ�J„u-�- 0-4�-- ��'',°�e. <br /> Have you started working without a permit4 _YES NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJect: _New_Addn _Alteretlon_Repeir TypeolProJect: _New_Addn _AlterMion_Rep�ir <br /> Show NumDer(M)oI ll+tures Show NumDer(N)ol flxfuree <br /> A/C–airhandlin units Toilet <br /> Forced air s slems Bathtub <br /> Gas i In Lavato wash basin <br /> Waler heater Shower <br /> Gas fre lace Kitchen sink&dis osa� <br /> Gas ran e Dishwasher <br /> Cluthes d er Clothes washer <br /> Ran e hood WTter heater <br /> Exhaustfan Sink service(barlmo /etc. <br /> Heat um BackOow revemer <br /> Unit healer Urinal <br /> Boiler Drinkin Founlaln <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Duclin Rool drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads I Other: <br /> 1 hemby certiy that 1 have read and eaamined Ihis applicallon and know tha same lo be Irue and correcl.All provision�ol lawt and ordinances qoveming <br /> Ihis type of xrork will be complied with whet�er specifeC herein or not Tha granl lnp ol a permit doee no�presume to B��e authonry to violate or cancel <br /> the provisicn ol any oIDer state or loral law regulaling conslructlon or iM1e pedortnance ef consin¢tion.That I am authorized b/Ue oxner of�hie properry <br /> to peAorm Iha wurk lor which apDlication is made and I compy vnlh the Slala Contract�rs Law 18.27 RCW and 298.200 WAC <br /> ���`� .v�c i,--r�--�-P `�i z7/,a <br /> O /Authod .O�entSigneture DS�e (Revised7201f) <br /> \ –��— <br />