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PERNiiT APPLICATION <br /> BUiLDING/MECHANlCAL/PLUI�iBINGISIGN/SPRINKLER/a�" �10LITION <br /> CITY OF EVERETT F tRMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 - 425-257-881 C- Fr,X 425-257-8857 -www.everetlwa.org <br /> APPLICP.','IONS.^.RE ACCEP?ED FROM E AM TO 4 PM � �J'"I z <br /> SITE ADDRESS: _TI OPEaTv Tnx H ? �T�I Z_ v�� <br /> 9zis— io +u A� sF ��sL�F�,._ <br /> LEGAL(or new conslmclion: Short Plat/subdivision Lot IJo._ (atlach copy of long legal descriptien) _�_ <br /> OWNER f'�,71 w S. YVI PhonelE�mail Z04 — <br /> Address �F � CitylSlale/Zip y� R" � <br /> 7�^p `( � L&ILic.# <br /> ONTR�A OR n <br /> Address ,�� �.. � NC PZ7d PhonelEmail y�.f- a�� -1r`� L�a .n E�'k'6. <br /> TENANT BUSINESS NAME <br /> Y CONTACT FOR PERMIT CO�t <br /> �Gn IGL (-.l.�YP�_/�� PhonelE-mail <br /> BUILDING PERMIT pPPL1.CATION CONTRACT PRICE Oi'WORK <br /> Existing Use of Building <br /> HEAT SOURCE: <br /> Proposed Use o(8uilding Gas_ Electric_ Other_ <br /> Building type: Single F�mily _Duplex_Townhouse _Mulli-Family _Commercial <br /> Type of project _New _Addition _ Remodel _Repair_T.I._Sign_Sprin/kler_Demolition_Change of Use <br /> DesCtiplion of Work(addifional space provised on fhe back�: A,�� ��5��L{"�p tn 0�`t <br /> NO tTrµG�Nra� 61�1f <br /> Have you started working williout a permi:7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa oi Projacl: _New_Addn _Alteration_ftepalr Typo of ProJact: _Now_Addn _Alterelion_Ropair <br /> Show Number(It)o/lixmres Show Numbcr(#)ollixtures <br /> � AIC—air handling unils I Toilet <br /> � Forced air systems � Balhlub <br /> � Gas piping � Lavalory(wash basir.) <br /> � Waler heater � Shower <br /> � Gas freplace Kitchen sink&disposal <br /> � Gas range � Dishwasher <br /> � Clo�hes dryer � Clolhes washer <br /> � Range hood � Water heale� <br /> � Exhausl fan Sink(service/bar/mop/elc.) <br /> Heal pump � Backflow preventer <br /> i <br /> Unit heater Urinal <br /> � Boiler Drinking Founfain <br /> Refrigeralion Floor drain <br /> � Woodstove Grease Irap <br /> Ducting � Roof drains <br /> I ��hzf I Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM othr.r: <br /> i � Number of Heads I Other: <br />` I hereby certify ihat I have read and examined this applicatian and know the same to be true and wrrecL All provisions ef la�r and ordinances goveming <br /> Ihis lype ol vrork v+ill be complied with whelher specifed herein or nol.The yran�ing of a permit does nol presume lo give authority�o violafe or cancel <br /> tl�.e provision ot any o�her state or local law regulaling consirudion or the p=rlormance of construction.7ha1 I am authorized by the owner of Ihis propetly <br /> lu peAorm�he work for which application is made and I comply with the Sia�e Con�ractors Law 1827 RCW and 296200 WAC <br /> J� N•r rs P�IA 1 II O �1�I2 <br /> OwncilAuthnrized Agent Signaturo <br /> Date (Revised 22017) <br /> /j�J�.a��t�fc S �f��,�r�Cc.;<, <br /> ��C,irc,r.� O� ��'�'c✓t'� a� l�Pi1��: Cc�[. -- <br />