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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 �:,X 425-257-6857 www.everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROPERN TAX M PERMIT M <br /> SITEADDRESS: �`_ - �' - <br /> 1 " i • �C. ,i i '.i�,� ��i (�J��.,� - � <br /> c 4', �,�tv.r' I�,cey 31v,1 �. , �i �� — <br /> LEGAL for new consiruction: ShoA PlaUsubdivision Lot No._ (attach wpy uf long legal tlescnpiron) <br /> OWNER �1,i��.v.�.� r.,.����,��� ��'i:,,`�- PhonelE-mail <br /> Address I �' ' r-LfG.�� 1 <br /> ,� CnylStale2ip �'�" `l��' '�� -- <br /> APPLICANT: _Owner Chvner'sAgeM CoNractor lConlraclofsAgenl _Tenani;m�s�n�o.aeapn.�oira�s.m��om��Pcw�e�meo.wn��mou-ac�i <br /> � r,.!r.� ,'.�,� ., L81Lic.i! �� �� �.���•-`� "� , ._ COEBuaLic.# <br /> CONTRACTOR !. <br /> Address � �,�� .t�" �t.. •{'�� A.�. . _°�i. , Phone�Email . ' . � i -' <br /> TENANT BUSINESS NAME CC'ITACT FOR PERMIT � . .�-+� <br /> .`� J I�...�. <br /> __ ' ����� �, . . , :.i <br /> \�',�,^i1'._ � -ir ��„ � �. PhonelE-mad .�iF. . �, . . . . ; i .; ; .. � ..c .,. <br /> BUiLDING PERMIT APPLICATION <br /> CONTRACTPRICEOFWORKt� / '% f�'�� �'�� ��l�'���"`� <br /> HEATSOURCE: <br /> Exisling Use of Building <br /> Proposed Use ol Building Gas__ Eiectric Other _ <br /> Building type� Single Family _Duplex_Townhouse Mulli-Family �.�Commercial <br /> T pe of pro ect Kew Addilion Remodel Repair 1 T.I. Si n Sprmkler Demolilion Chan e o�Use <br /> DESCRIPTION OF WORK�additinnul space p�ov�eed on tlra back�: ,_. <br /> ,i... , . .. � . . . f; • . ,. ' . ,, , ,. . ,. . . � I .� , <br /> MECHANICAL PERMIT APP�ICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pro�ecl: _New_Addn ✓Alleratlon_Repair Type ol Project: _New_Addn _Alteration_Repair <br /> Show Numbcr(#J o!fi+lures Show Number�N)o!/iYfures <br /> � AIC-air handlin unils Toilel <br /> ForceA air s slems Balh�ub <br /> i Gas pipin Lavalo (wash basin) <br /> Water healer Shower <br /> Gas lireplace Kifchen sink 8 disposal <br />� Gas ran e Dishwasher <br /> Clolhes d er Cbthes washer <br /> Ran e hood Waler heater <br /> - Exhausl lan Sink(servicelbar/mo Ieic.) <br /> � �� Backflow prevenler <br /> Heat pump <br /> Unit heater � Urinal <br /> 6oiler � Dnnkin Fountain <br /> Refn eration Floor drain <br /> Woodslove Grease tra <br /> Ductin Roof drains <br /> Oiher Medical Gas <br /> SPRINKLER I SUPPRESSION SY�TEM otner: <br /> Number ol Heads '� Other. <br /> I��creby�.cil Fy D�al I harc i-�o���c�omncd it�s apP�'��Lo, <br /> ��ii�nnow I�re same�o�e 1•uo and corted.All piov s�o�s ol Inws and o�:nenceF g"�emiag I�rs type ol woM1 wtll ba u�mD�✓�d <br /> w11��+'��u�er specAmd hermn o��ol The granbng ol a pertnA tloes nol pmsume lo gne aulhon�y to vrolate or c.:ncM I�e p'ons�on o any o�s Law 18 27 RCW an0 296.200A WAp tl�o� <br /> 1 nai i..��.i aulhonzed 6y lhe owner ol this proOe�Y�o pedortn Ihe work for wtin�applratwn Is maGe anC I compiy with tlie Stale Cnnlr2q,�r <br /> . _ . `�, � <br /> Date (Revised6/20f2) / <br /> Ownr.dAulhodzedAgenlSignaWre � � <br /> l � <br />