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PERMI f A►PPLICATION <br /> BiJILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLiTION <br /> CITY OF EVERETT PC-FMIT SERVICES g --ll --ll <br /> 3200 Cedar St., Everett, WA 98201 - 425-257-8810— FAX 425-257-8857—www.everelbr�a.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS:��/� ^f� iLi� /� � PROPERNTAXtt ' PERM_I��� _,n� <br /> (J /I(i V 1!, <br /> LEGAL for new conclruction�. Short PlaUsubdivision Lot No._ (a�tach copy of long legal description) <br /> OWNER I'��kA'��L S� N/Rn�inc��T PhonelE-mail <br /> Address �'t 1 S /G ��� S�� ' Ci�ylSta�e/7ip <br /> CONTRAGTOR L&I Lia # <br /> PhonelEmail <br /> Address <br /> TENANT BUSINESS N/A, ME / CONTACi FOR PERMIT <br /> � tl Ct-1,��"�- F�arn i �y �'70nL <br /> ����,�.e,j�f PhonelE-mail <br /> BUILDIkG PERMlT APPLICATIOlJ coN7RAcr PRICE oF woRK_ <br /> HEATSOURCE: <br /> Existing Use of 8uitding <br /> Gas Elechic__ Other_ <br /> Proposed Use of Buil�ing -- <br /> Building type: _Singie Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type cf project: _.New _Addition _Remodel _Repair_T.I._Sign_Sprinkter_Demolition_Change of Use <br /> Descriplion of Work�adtldional space providedon the back): <br /> �c" 1.41,,�� T�)»q � �i'Cn�� i jtf/�?C��O� <br /> Have you started working wilhout a permit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUM8ING PERMIT APALICATIQN <br /> TypeofProJoct: _New_Addn _Alteralion_Repair TypeofProJect: _New_Addn _Alteratloii_Repalr <br /> Show Number(#)o/!ix tures Show Number(t!)o!/ixtures <br /> � AIC-air handling units I Toilel <br /> � Forced air syslems � BathWb <br /> Gas piping I Lavatory(wash basin) <br /> Waler heater Shower <br /> � Gas fireplace I Kitchen sink,i�disposal <br /> � Gas range � Dishwasher <br /> Cbthes dryer I Clothes washer <br /> � Range hood I Water heater <br /> IExhausl(an � Sink(servicelbadmop/etcJ <br /> Heat pump � Backflow prevenler <br /> � Unil heater � Urinal <br /> � Boiler Drinking Fountain <br /> � Refriaerelion FloorJrain <br /> � Woodslove � Gr,ase trap <br /> � Ducting � Roof drains <br /> � O�her Medical Gas <br /> SPRINKLER / SiJPPRESSION SYS9'EM I Other: <br /> i I Other: <br /> I Number of Heads <br /> I herehy ceAify that I have read and examined this application and know Ihe same to be Irue and correcL All owvisions of laws and ordinances poverning <br /> this type of work will be complied nilh whether specified herein or not.?he granling of a permit does nol pre>ame lo give authority to violale or cancel <br /> Ihe provision of any o�her stale or local law regulaling construc�ion or�he performance of construclion.That I am authonzed by�he owner of Ihis propetly <br /> to qeliorm the vmrk for which applicalion isaude an I comply wi�h the Sta e CoNractors Law 1827 RCW and 29620�WAC <br /> � � � � D li <br /> ` �.� ��-�.��. (Revised22017) <br /> OwnerlAuthorizedAgentSi9naWro D te <br />