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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROPERN TA%M PERMIT R <br /> SITE ADDRESS_ , , � - - � - <br /> , �� . , . .. ' ` <br /> ;�� � ; � , <br /> � Lot No` (altach copy ol long legal descnplion) <br /> LEGAL lor new consWct�on: Shon PlaVsubdivision <br /> _ 7 �� , <br /> OWNER ' ") PhonelE-mail ` '!� 4- �� -� � U <br /> � ) .�. <br /> Address '� , i ' � � i CilylStale/Zip_� / (' ` <br /> CONTRACTOR ��: c L 8 1 Lic.il � <br /> r" `]�� �� <br /> Address ;� `�� = �7 � � /�% � - - PhonelEmail � ;) ,j � J <br /> TENANT BUSINESS N ME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION <br /> CONTRACT PRICE OF WORK 1�� �t, G'� <br /> HEATSOURCE�, <br /> Existing Use of Bullding l � »� A' � �—�- � � <br /> �^ �as_ E�ectric_ Otner�V�'l� � <br /> Proposed Use of Building l 1��.L� <br /> Building type: _Single Family _Duplez_Townhouse _Mutli-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_,Demolition_Change of Use <br /> Descrip�ion of Work(additional space provided on the back): <br /> '..��- �- �� �'!iti'� ���� �/�'�� _ <br /> Have you slarted workfng wilhoul a permit? _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: _New_Addn _Altoration_Repair Typu ol Pro�ect: _,Naw_Addn ,_Alteratlon_Repelr <br /> Show Num6er(M)of fizfures Show Num6er(N)of lixfures <br /> Todet <br /> A/C-air handling units patMub - <br /> Forced air s stems Lavatory(wash basin) _. <br /> � Gas piping Shower _ <br /> Waler healer Kitchen sink 8 disposal <br /> Gas tireplace Dishwasher <br /> Gas rznge Cbthes washer <br /> Clothes dryer � Water healer <br /> Range hood <br /> Eahaust fan Sink(service/bar/mop/etc.) <br /> Backflow preventer <br /> Heat pump � Urinal <br /> Unit heater Drinking Fountain <br /> Boiler Floor drain <br /> ReGlgeralion Grease trap <br /> Woodstove Roof drains <br /> Ducling Medical Gas <br /> Other <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> � Number of Heads <br /> I other: <br /> I hereby cetlify that I have read and examined this applicalion and know Ihe same to be true and corred.All provisians ol laws and orainanres governing <br /> this type ol work�vill be complied with whet�er specifed herein or not.The granting ol a pennil does nol presume to give aulhority lo violale or cancel <br /> U�e provision of any olher slale o�Oca(on is made alnd I comp�y wi h IhehS ale Cont actors la v,1B.27 RCW 1a1nd 296200 WACY�he owner of this property <br /> lo pedorm Ihe werk for which app� <br /> (��. �/ /' �,C—� �- ���' - � � (Revisen 2R017) � <br /> OwnerlAu— L— hon=�d�9entSigpeniro <br /> n � I.� <br />