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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDE'YIOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—wwav.evereriwa.o gs_!� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO<PM I a <br /> SITE ADDRESS' C'� PROPER N PERMIT t <br /> S�,� J 3 � �c.�c' ` � ' L� ) ' 12—U 3�--�' <br /> LEGAL for new constmdion: Short Plat/subdivision � t Na.� (attach copy of lon9�e9al descnpGon) <br /> OWNER � � �j /'1 � .E Phone/E-mail � �-' G� / � <br /> Address - �� L�t' : � ary�siacerz�a - / ) � . O <br /> , -. �� � <br /> CONTRACTOR '�•l � C' � /7 " L&I Lic.# _ � � <br /> Address � V� � . �_](�t,) � L. - C I (,) � PhonelEmail �s- - ,5 'J��.S � <br /> TENANT B SINESS NAM CONTACT FOR PERMIT <br /> � <br /> PhonelE-mail �)p� G{�/ � <br /> BUlLDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> HEAT SOURCE: <br /> Existing Usr.ot Building � <br /> Proposed Use of Building _ Gas Eiectnc_ Other_ <br /> Building rype: ' .�Single Family _Duplex Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel _ .Repair_T.I._Sign_Sprinkler_Demolition_Change ot Use <br /> Description of Work(additionalspace provideAon the bock/: <br /> -}��l(�' �l G� C 'E. C��i�� O�,vl <br /> Have you sharted working without a pertnit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type oi Prqect: _New,_Atldn _,Alteration_Repair Type ot Project: _New_Addn _Alteration_Repair <br /> Show Number ryl)o//ixiures Show Number(#)ol/iutures <br /> � A/C-airhandlin unils � Toilet <br /> � Forced air s stems � Bathtub <br /> i Gas pi in Lavato (wash basin) <br /> Water heater �� Shower <br /> � Gas fireplace � Kitchen sink 8 disposal <br /> � Gas ran e Dishwasher <br /> ' Clothes d er �I C�sthes washer <br /> Ran e hood � '.Jater heater <br /> Exhaust fan ' Sink(service/bar/mo /etc.) <br /> � Heat um Backflow reventer <br /> Unit heater Urint <br /> � Boiler � Drink�.� Fountain <br /> Refri eration � Floor drain <br /> � Woodstove 3rease lrap <br /> � Ductin '� Roof drains <br /> � Other � Mediwl Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> �� Number of Heads Othec <br /> I hereby cetlity ihat I have read and examined this application and know the same to be true antl curtect.All provisions of laws and ordinances goveming <br /> this rype of work vnll be complied with whether soedfietl herein or noL The granting oF a permit dces not presume to give authodry to violate or rancel <br /> the pmvision o1 any other state or local law regulaling wnsimction or ihe pedortnance of wnswdion.That I am authorized by the ovmer of this properry <br /> to pedorm�he v.�rk �eh�PPlication is made antl I comply with lhe State Contraclors Law 1827 RCW and 296200 WAC <br /> ��c.���l,l..l ( Z (S— � � — <br /> OwnerlAuthorized Agenl Signature Date (ReV1������ <br />