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� <br /> PERMIT APPLICATION <br /> BUILDING/MECHAI�ICALIPLUMRING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES / �./Z '�IZ <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810–FAX 425-257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCcPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: \ PROPERTY TAX N PERMIT p <br /> •ZCp 23�t� �2� W �t��'�. '4� '2y,``1,�C2GO�iG1 O C� '-d�� � <br /> LEGAL for neN•conslruction: Short Plat/su6division Lol No._ (attach copy of long legal tlescnplion) <br /> OWNER � E J 'c ' � <br /> Phone/E•mail �� <br /> l�ZOC '2� � � �\ ��7¢y � "'�J <br /> ddress �� ��- City/Sla�e/Zip <br /> CONTRACTOR C' �i 11d��.J���tL�RL �M-lS L&I Lic.# D`L '� � >5� <br /> 4�) ��`t • ;3� � ,,...� <br /> tldress 3"C`l� r.,l.t R'��`�- C ���� � \�� � P�one/Email �,�o �� re u- 1CL <br /> TENANT BUSINESS NAME CONTACT FOR RERMIT � <br /> v.�.a�R-\� jL.�?>� tZ-TS�I�� . _ <br /> �.�—��L PhonelE•mail kA�. J\>-. L�'� �L. C. v ¢ �' .. \� , G��^ <br /> BUILDING PERMIT APPLiCATION CONTRACT PRICE OF WORK ��° b�• — <br /> Existing Use ot Building �`��-�-��� t aTF��-�o� c,�j4-+Q_c,c nu HEAT SOURCE: <br /> Proposed Use of Building ��1'�^� �Z�- ��"��l E � Gas_ Electnc_ Other_ <br /> Buiiding type: _Single Family _Duplex__Towni�„use _Multi-Family _Commercial <br /> Type ot projecl: _New �Addition _Remuu=! _ _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(additional space provitled on the back): <br /> IAl`,i�'-�rr-��.�,1 p� L,x���.,c �x��L.�v�Z +tv�nl��.l(.� �v vu�i ���i <br /> ��JTetih,.�i.c J'�" ��.��.h��.lf.� <br /> Have you started working without a permit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ypeotProJect: _New_Adtln _Alteratlon_Repalr TypeolProJecL• _New_Addn _AlteraJon_Repair <br /> Show Num6er IN1 01/lxtures Show rvumberlNl oP flatures <br /> A/C-air handling units Toilet <br /> � Forced air s stems � Bathtub <br /> � Gas pipin Lavato (wa;h basin) <br /> � Waler heater I Shower <br /> I Gas fire lace Kitchen sink&dis osal <br /> � Gas ran e Dishwa�her <br /> � Clothes dr er � Clothes washer <br /> � Ran e hood � Water heater <br /> � Exhaust fan � Sink service/bar/mo /etcJ <br /> Heat pump I Backflow reventer <br /> Unit heater � Urinai <br /> Boiler Drinkin Fountain <br /> Refrigeration I Floordrain . <br /> � Woodstove Grease tra <br /> I � Ductin Roof dreins <br /> � Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> Numbe�of Heads I Other: <br /> I here0y certity Ihat I have read and ezamined tnis application and know ihe same lo be irue antl correct.All provisions ol laws antl ordinances goveming <br /> �his type ot�mrie witl be complied vn��whelher sperfied herein or noL Thc�ranting of a permit does noi presume to give aulhority to violale or wncel <br /> Ihe provision ol any other stale or loc�-taw regulating construclion or Ihe perfortnanae ot conslruction.That I am aulhorized by lhe owner ot Ihis property <br /> lo peAorm the work lo!which applicati 3 atle and I culn ly with t�ilraclors Law 1P.27 RCW and 296.200 WAC <br /> iti� � ( � I <br /> � SG�c�.l_ � -�?�� � C`��1 ` �'Z_ <br /> OwnedAuthodzed Agenl Si�nature Date (Revfsed?/2017) <br /> I <br /> � . <br />