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I . <br /> PERMIT APPL�CATION <br /> BUILDINGIMECHANICAUPLUMBING/S1�NISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES ��aCJ `�Z <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www•everettwa.org <br /> APPLICATIONS ARE 4CCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRE33: PROPERiYTAXM � _ <br /> 7 o VL. <br /> LEGAL for new construction: Shori PlaUsubdivision Lot No._ (etlach wpy of Iong IeBel tlesutptlon) <br /> OWNER L-(., PhonelE-meil <br /> Addresa oC � � -] CitylSlate/Zip <br /> APPLICANT:_Owoer OwnelsAgent Contractor ContractoYsAgenl _Tenant(mm�proNa.eianxmco�wmrmmmso+�»rioao«omm�.spau) <br /> CONTRACTOR���Q Yf � W Q C�r L&I Lic.# COE Bus.Lic.# <br /> Address �� �j �0 1 PhonelEmail L�,-� <br /> A T U IN S NAME CONTACT FOR PERMIT <br /> PhonelE-mail ��� 303 - 8'lob � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exisling Use of Building n n^ '��v''�� HEAT SOURCE: <br /> Proposed Use of�B/u�ilding n4 ^ � '��`L�� Gas Elec�ric O�her <br /> Buiiding type: 1vingle Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T e oi ro'ect: New Addition Remodel Re air T.1. Si n 5 rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(edditional spece providedon the beck): <br /> l j.�����-- ✓��"`� ,'�O—Od <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type o1 ProJect: _New_Addn _Alteretion_Rapalr Type ot ProJact: _Naw_Addn _Altaratlon_Rep�ir <br /> Show Number(N)ol flxtures Show Number(M)ol8xturea <br /> A/C-air handlin unils Toilet <br /> Porced air s stems I Bathtub <br /> � Gas i in Lavato wash basin) <br /> Water healer Shower <br /> Gas f re lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clolhes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/barlmo letc. <br /> Heat pum BackFlow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> � Refri eration Floordrain <br /> Woodstove Grease lra <br /> Ductin I Roof drains <br /> Other Medicaf Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> Number of Heads I Olher: <br /> I hereby cerlRy Ihat I Aeva read end exeminetl t�ie eppi�cetin^enE know tha aame to be true end co�recl.Atl pmNsons ol law�entl oNinencef qoveminy I�ie type U xrork wiA be canPM1eE <br /> with wfiel�er speclGeE�ercin w not.Tha qrantinp ol e pertnM does not proeume lo qNe aNhorlty to vblate a rancel t�e qwl�ion ol any ot�m etate u bcel Mv repulallnq cantln�� <br /> 7Tat I em aNhorizeE Gy t�e owner ol tNs properly to perlam t�e work br wTkh applicellon b mede�n01 campry wM the Sl�te Canb�.la�Lnv 1827 RCW m7 298 200A WAC. <br /> � ����., � ���91 � z <br /> Ow�er uthorized ntSlgnelure <br /> �e�- ,Ra�ised 62�,2) <br />