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I �, <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <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 E AM TO�PM <br /> SITE.�DDRES3: PROPERTY TAI(II PERMIT� <br /> � ► z.^_i S I�✓c.L L,t✓i,J VZcnn � "° <br /> LEGAL tor�w conslruction: S�on PiaUsubCivisfon LM No._ U��ach copy o�b'p bp�l de�alplbn) <br /> OWNER C-' /T� Ur YivGiLi,�f PnmerE•mail 2 � ��7 <br /> dArou CirylSWtelZlp � G� .P✓" t -wn . g <br /> CONTRACTOR Ol.�f� �- L S I Lie.k <br /> ddreae Plwne�Eme�l <br /> TENANT BUSINE33 NAME CONTACT F R PERMIT 1 4�y . 7}����5• <br /> 1�� �I�1' � �{' PhrndE�rnail �1��te� <br /> BUILDING PERMlT APPLICATION cONTttaCT PRiCE OF WORK <br /> Exfating Use ol BuiMing ���E- �T��� _ HEAT SOURCE: <br /> Proposed Usa of Building l��+^'�F Gea Ekdric Mher <br /> Building type: _Single Family _Dupiex_Townhousa _MuRi-Family ��ommercial <br /> Type of projecl: _New _Addition�Remodel _Repair ,�l'.I._Sign_Sprinkler_Demolition,_Change oi Use <br /> Deauiption of Work(eddilronai space provideAon tne a�ckJ: <br /> G H a�.�� -rv w A ru-> ��,�- y c;vr�e�- r.��s•�.�•._ bq I h roon�, <br /> move wmdcv.l �+ wd ��cul <br /> Have you slaRed working without a permlt7 YES �NO <br /> MECMANICAL PERMiT APPLICATION PLUMSING PERMIT APPLIC��� <br /> TypaolProject: _Naw_Adtln _ANeredon_Rep�lr TypsolPro�ect: _Nwi—�Edn _Alt.ntlon_Rap�ir <br /> Show Num6er )ol llxfurea Show Numb�r W�+hnsr <br /> A/C-airhandlin units Toilel <br /> Forced eir s stems Bethtub <br /> Gas i in Laveto wash baain <br /> � Waler heater Shower <br /> � Gas fre lace Kilchen eink 3 Eia osal <br /> Gas ran e Diahwseher <br /> Clothesd er C�ytheewasher <br /> Ran e hood avaterheakr <br /> Exhaustfan Sink eervicel�erlmo letc. <br /> Heat �m Badctlow reventer <br /> Und healer Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floordretn <br /> Woodstove Grease Ira <br /> Ductin / ,:: — D.:�-r o Roof drain� <br /> Olher Mediwl Gaa <br /> SPRINKLER/ SUPPRESSION SYSTEM a�'� <br /> Number of Heads I Other: <br /> I hereby cerliry�ha�I have read and examineE ihis appliwtion end know ihe same lo be Uue and co:recL i.11 pmvisiona W IeM a�C oNhwntts poveminp <br /> this rype of work wlll be wmplieE wil�w�elher specifieE heieln or not.Tha OraMinO ol a permil dcea nol prosume to pive auMOMy�a Wdate or cenal <br /> lhe provision of any olher stale or local law requlating canslrudion or ihe pedortnence ol conatn�dlon.That 1 am eWtrodze0 W ihe owner ol t�is properry <br /> (p pe t�e work for.Mich application is made anC I compN�+'��h the State Contractora Law te.27 RCW anE Y90200 WAC <br /> ,'�� 2� l�0 1 Z_ <br /> Dele (Revised 7/201 f1 I <br /> OwnerlAuthorizetl ABenl Signeture � <br /> '/ �'✓�� �� <br />