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, <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810-FAX 425-257-if857-www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM S_��3� ,� <br /> SITEADDRESS: PROPERIYTA%N P ITi <br /> :;�� ,,v � G do��-rr �✓.c. 9�',�'3 O5�OZ� <br /> LEGAL lor new consWaion: Shon PlaVsubdivision Lot No._ (altach wpy ol iong legal descnption) <br /> OWNER � F�e:T � :( ` PhonclE-mail <br /> naa�ess � �-j �� , - , vp City/State2lP - / 67T /,o. 98a03 <br /> CONTRACTOR -./,.�r. ! /�.+�5 1TC, L 8 I LiC.# •Nl " SR.AJ <br /> nddres�j/r� , T�/�/ , ��'� , ,o�.�i PhonefEmail y 3�a—/y(J <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT G+ �2 U� <br /> Phone/E-mail z7�99/ v3 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /x2� <br /> Existing Use ot Building�c6— SL�.i</���7�L�Y HEAT SOURCE: <br /> Proposed Use of Building �6S/L�GN�� Ges_ Eleclnc Olher <br /> 6uilding type: t�Single Family _Duplex_Townhouse _Mulli-Pamily _Commercial <br /> Type of projec T_New �Addition _Remodel �Repair_T,I._Sign_Sprinkler_Demolition_Change of Use <br /> Desaip�ion Of Wodc(etldifionel spacx provided on Iha Aack�: <br /> /ef.T i��i�( NJ.J bft4/t./M'i L✓AdGi <br /> /vSiALC, NF,t,�J .h/f.ADr�<, i3r,Icc.O 1 GL.�''S/1 <br /> Have you started working wfthout a pertnit7 _YES 10 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeotProJect: _New_Addn _Altoratlon_Rapalr TypeolProJact: _Naw_Addn _Alleratlon_Repalr <br /> Show Number(N)ol/ixturcs Show Number(M)o//Ixturea <br /> NC-air handlin unils Toilet <br /> forced air s stems Bathtub <br /> Gas ipin Lavato (wash basin) <br /> Waler heater Shower <br /> Gas fireplace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clolhes d er � Clothes washer <br /> Ran e hood Water heater <br /> Exhausl fan Sink(service/bar/mop/etc.) <br /> Hcat pump BackOow preventer <br /> Unit heater I Urinal <br /> oodcr Dnnki� Fountain <br /> Relri eration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby cerllly Ihat I have rcad and examinetl this application and know the same lo be Irue and conecL All provisions of laws and ordinances goveming <br /> ihis type of woik wiil be complied wilh whether specifed herein or noL Tha granting ol a pertnit tloes nut p�esume lo give authonty to vlolale or cancel <br /> the provision ol any other slale or cal law iegulall,�g construclion or Ihe pedormance ol constructioa Thal I am aul�orized 6y Ihe owner ol Ihls property <br /> to pertorm Ihe Wo�k-la u i ppli ation is made antl I comply wilh the Stale Contracbrs I.nw 18.27 RCW aud 296200 WAC <br /> .� i�//,v ✓IJ �V� ( <br /> Owno•lAutiorized7Cg nl5lgnaluro Date (Revised7/20f7) <br />