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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evere�t, �NA 98201 -425-257-8810— FAX 425457-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T04 PM Q �7'�f� <br /> SITEADDRESS: _L, uG S ' f 1 PRORiYTAXq O � PE M�Tp ^ �^ Q <br /> ' � �"1 ��0'i� L <br /> LEGAL tor newwnslruclion: Shoh PiaVsubdivisioq ._ Lo�No. _ (allar.h coFyel iong Ie9al description) <br /> OWNER s��JJ[(Z � �QOSf� Phone�E�mail <br /> Address �Q [.V 4 (,. J�(,1�. CirylSlatMZiP �p��N� W A . �p�� <br /> CONTRACTOR Ly 1�1 �1 � � ,1 L 8 I I.ic. N V�f� (JG-Ll/� `1 <br /> �AAfC55 �1 � �I I �j/��/I �'hOr,CiEmail � L/���� I 1 <br /> TENANT 9USWESS NAM11E CONTACT FOR PERMIT <br /> 1 f{� }�G�yl�'�} Pronu[-ma:l M{1�@ W�1 . eoW� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Q�DOD <br /> Existing Use of Buildinc� ��l(.E_ HEAT SOURCE: <br /> ProposeC Use of BuilCing �E�« Gas _ Eiectnc_ Otl,er__ <br /> Building type: _Single Family �Duplex�Townhouse __Atulti-Famlly _Commercial <br /> Type of projecC _New _AdCition _Remadel _Rcpair,�T.I._Sign_Sprinkler_Cemolition_Chan9e ot Use <br /> Descripiion of 4Vark(odditionnl space providedan Ihe bacd): <br /> A�l� bucT l� �rlt- � 3 i3ar�+ FANS <br /> Have you started working without a permit? _YES �NO <br /> MECHANICAL PERMIT APPLICATION PI.UMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn ,�Alter.�.lion _Repair Type of Projecl: _New_Addn _Nterelion_Repair <br /> 5how Number(YJ olli:tures Show Num6e�(tl)ol li.fures <br /> AIC—air handlin9 units �I'oi!et <br /> Forr.ed air syslems Oalhlub <br /> G:+s piping I.avatory(wash t�asin) <br /> Water henler Shwrer <br /> Gas freplace I<itct�en sink 8 disposal <br /> Gas ranGe Dish::.sher <br /> Clothes dryer � Clothes�:�ashcr <br /> Rnnge hoaf NJater heatr.r <br /> Ezhaust lan ��Sin't(;crvicclbadmop!etc.) <br /> Fleat pump �aci,�ow prevenir.r <br /> Unit hralr.r � Urinal <br /> Boilcr DrinV.ing Faunlain <br /> Refriqeralion F(oor droin <br /> Woodstovr. � Greasc trap �, <br /> Ductinc� TJ Zuu�.S Rooldrains <br /> Olher I Med'cal Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM o�l,er: <br /> INumberof Heads I Other. <br /> I he�eby certify that I havc read antl examined Ihis apF�iwtion and know Ihe s:une to be Ime and mrtect.All provi:lens ot lavis and oNinances g�'+eminy <br /> Ihis Ivpe of vrork wll be compiied vnlh�:he�her;peci(Cd here�n or nol.I he gmnling of a pC�mii doe5 r.oi pr25ume IC r,ive aulhority(o violatC or wn[el <br /> Ihu provision ol any ot�er stale or bcal lavr reeJulating censWUiai or the peAermance ol coi�slructioa That I am au'hodzetl by Ihe o�arier ef this pmperty <br /> lo pe Ihe v:ork lor uhich ap{:licalion is made and 1 r.omply v.iih l�e SI.!e Cnniractvs W�.v I8.27 RCW and 296.2006VAC <br /> OwnerlAuthariz en15ignaturc �O� (R�:ised2/2011) <br />