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r ` <br /> � • <br /> PERMIT APPLICATlON <br /> BUILDINGIMECHANICALIPLUMBINGI�IGN/SPRINKLER/DEMOLITION <br /> CITY OF E'✓ERETT PERMiT SERVICES <br /> 3200 Ced2r St., Everett, WA 982�1 -425-257-8810— FAX 425-257-8857—www.everettwa.org` t( <br /> pPPLICATIONS ARE AC-^.EPTED FROM 8 AM TO 4 PM <br /> PROPERTV TAX q P MIT N - O a <br /> SITE ADDRE�SlS: <br /> C • 7 — t�c i l, i� j� <br /> LEGAL(or new construction: Short PlaVsubtl�vision <br /> Lol No._ (attaU coPY o�bng legal tl�scaPhon) <br /> r" ' <br /> 1CI-Gl... PhonelE-ma�i ��� ��>�—Cy�� <br /> OWNER,-;('i_" � � � - (�6-, <br /> � ^ City/State2ip � � �- � ��—Z� - —(Cd <br /> Adaress i�� d� t-'<' <br /> CONTRACTOR 1 J��LU l.lh--f ' � � C'� L 8 I Lic.# 7�C U�'«� �t L n Z <br /> �y1 /� � L <br /> /� r C �] � I PhonMEmai a.�-�? �_ � <br /> Address `��C� �- � � �`'�--�;. =�- \ ���S�L� �Ll- 16�1,�L <br /> CONTACT FOR PERMIT 1 1 <br /> TENANTBUSINESSNAME �,�i��` �K�� �� �„�c��� <br /> Phone/E�mail -� 1 <br /> BUILDING PERM:T APPLICATION coNTruC7 PRICE OF woRK �\�O-� <br /> HEATSOURCE: <br /> Exisling Use of Building_.__- <br /> Gas_ ElecVic_ Other_ <br /> Proposed Use of Building_ <br /> Building type: _Single Fav�ily _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of projecl: _.New _��ddilion _Remodel _Repair_T.I._Sign_Sprinkler_,�molition_,Change of Use <br /> Descriplion of Wo�k(addrtional spa:^p�ovided on fhe back): <br /> Have you started workinr,without a pertnit7 _YES _NO <br /> MECH/lNIGAL PERMIT APPLICATION <br /> PLUMBING PERMIT APPLICATION <br /> Typn af Project: _New_Addn _A��eration_Repair Type of Project: _New,_Adtln _Alterelion_Repzir <br /> Show Number(#)o/�xtures <br /> Show Number(N)o!fixf ves Toilet <br /> A/C—airhandlin units Balhlub <br /> Forced��r s stems Lavato (wash basin) <br /> c;�e;ioing Shower <br /> Water he3ler Kitchen sink&disposal <br /> Gas fireplace Dishwasher <br /> Gas ranc`e — Clothes washer <br /> Clolhes dryer "- Water heater <br /> Range hood Sink(servicelbarlmopletc.) <br /> Exhaust fan Backflow preventer <br /> Heat ump Urinal <br /> Unit heater Drin4in Fountain <br /> Boiler Floor drain <br /> Re(ri eration Grease trap <br /> VVo�dslove Roof drains <br /> Dur.tin <br /> Medical Gas <br /> Other <br /> SPRINKLER ! SUPPRESSION SYSTEM arer: <br /> —'— - Othar. <br /> Number of Heads <br /> I hertby certiy thal I have reatl and exam�ned this applica9on and know Ihe same to be true ar.d cor�ecl.All provisions of laws and ortlinances Boveming <br /> Bus type of work will be wmplied vnth vA�ether speclfied herein or not. The gran6ng of a pertn�t does not presume to give authority to�ioiate or cancel <br /> �he provisioi of any other sta�e or loca�law re9ulating consirustion or Ihe pertortnance of cor.struction.That i am authorized by lhe owner of Ihis property <br /> ro pedorm me vrork for which application is inade and I comply vnth the State Contractors Law 1827 RGW and 296200 WAC <br /> � l� � (� ��, (Revised?J2oit) <br /> edAuthorized A9ent Signature �a�z F/� <br /> � <br />