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.;�, _ <br />;`,� <br /> ��`���i PERMIT APPLICATIGN <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLERIDEN70LITlON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810– FAX 425-25i�8057–www.everettwa.org <br /> APPLICATIUNS ARE ACCEPTED FROM 8 AM TO/i PM �.2 �.�p—f � <br /> � W� PROPERNTA%N PERMIT# <br /> �1 ^ '3C��. �� - 028' <br /> ., LEGAL for new conslruction: Short PlaVsubdivision Lot No._ (altach copy of long legal description) � <br /> x ; ' I c� j I ,.11 <br /> �y ��-'� OWNER �C'� T(�Z: �. � �1,f�/�� PhonelE-mail l-rZS-��i ' �7 Yl�� � W WI��L (•�u <br /> � �+ <br /> i� �+;'1 �/ � <br />�, .,,,....:.� Addres� �• (J� �� r -rj � CitylState/Zip G �y\ �}� <br /> �:,^,ri-..�' <br /> CONTRACTOR � C'�� C���� L 8 I Lic. # <br /> Address �'��,J�j2, PhonelEmail <br /> TENANT BUSlNESS NAME C NTACT FOAR�\p�RMIT (� o_ � <br /> ��Fc�U,- V�v1,`�G . \r� <br /> �C- ' P one -mail 1���~1J �" ' <br /> BUILDINt, PERMIT APPLICATION CON7RACT PRICE oF WORK ��(9b-��—' <br /> Existing Use of Building Wl HEAT SOURCE: <br /> Proposed Use of Building �' �lil" "' Gas_ ElecVic_ Olher_ <br /> Building type: _Single Family _Duplex+Townhouse _Multi-Family �Commercial <br /> Typeofproject: _New _Addition �Remodel _Repair_T.I._Slgn_Sprinkler_Demol(tion_Change ofUse <br /> DesCrinti0n o(Wofk(addifional space p�ovided on fhe bacR): <br /> 1 � <br /> ��;� 7oJ�� <br /> Have you started working wilhout a permit7 _YES ��O <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJoct: _Now_Addn _Alteration_Ropair Typa of ProJect: _Nnw_Addn _Alteralion_Rapalr <br /> Show N�mber(tl)ol lixtures Show Num6er(N)o/flxfures <br /> � A/C-air handling units _ I Toilet <br /> Forced air systems _ I Bethtu� <br /> Gas piping __ � Lavatory(wash basin) <br /> Water heater _ � Shower <br /> Gas fireplace Kilchen sink&disposal <br />�;. - � _ ( Gas range _ � Dishwasher <br /> Clothes dryer _ � Clothes washer <br /> Range hood _ Water heater <br /> � Exhaust(an _ Sink(service/Gar/mop/elc.) <br /> Heal pump _ I Backflow preventer <br /> Unit heater Urinal <br /> � Boiler _ � Drinking Founlain <br /> Refrigeration _ Floor drain <br /> _ � Woodstove _ � Grease trap <br /> Ducting _ Roo!drains <br /> � Other � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM _ I Other <br /> Number of hleads <br /> � I he�ehy cenify that I have read and examined this applica�ion and know the same lo be true and correcL All provisions of laws and ordinances governing <br /> Ihis type of work will be complied wilh whether specifed herein or noL The granling of a permil does nol presume to give aulhorily to violale or cancel <br /> Ihe pwvisi any olher slate o local la�v regu ' onsUuclion or the performance of consirudion.Thal l am authorized by Ihe or+ner of Ihis property <br /> to pe rm t e wor r which a ba�ion is matle an mply tale CONractors Law 18.27 RCW and 29G.200 WAC <br /> � >�,� �. I 2 � '�=, 'pl0 <br /> OwnedAuthorized Ac�ent Slgnaluro Dale (Rev�sed7220f0) <br />;1... � � 1/ <br /> yi <br /> � . _ _ �, .. - z;:�'� H w:, -:�'I <br /> ���$...Y_ . '�� ��`..±a � �.._+: . .. dIP.�, 1�^1�f _ <br />