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��Aen�.a( � Exs�sas.rs ��RM�d�s i_ <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLERiDEMOLITION <br /> CITY OF EVERETT PERINIT SERVICES <br /> 3200 Cedar Si., Everett, WA 98201 -425-257-8810-FAX 425-257-8857 -www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITEADDRESS: PROPERNTAXp ERMITS� �V � <br /> oQp,3 /.? . SE. �'708 <br /> LEGAL lor new conslm•-1ion: Short PlaUsubtlivisic�EESl��/FL� i�1K Lot No.�O (a�Wch copy ol long legal descriplion) j/4/l� ��Q � <br /> OWNER / µd ' .1✓�4 Phone�E-mail �J8- /yy o <br /> Address /S �Ik /� Cily/S1atMZip � (LV 7 �.�l� <br /> CONTRACTOR / ' N L 8 I Lic.# EM9 G 9107 V G <br /> Address !f Phonc/[mail.�s �7a �yy� <br /> TENANT BUSINESS NAME CONTACT FOR PEHMIT /� 6 �IJ'f,T 9G�Y�OS <br /> Phane/[-mailC/�E/QQ / IY <br /> BUILDING PERMIT APPLICATI6N CONTRACT PRICE OF WORK <br /> Existing Use of Building _ HEAT SOURCE: <br /> Proposed Use of Building_ Gas Eleclric__ Olher_ <br /> Building type:�Single Family _Duplex_1'ownhouse _Mulli-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repaii_T.L_Sign_Sprinkler_Demolilion,_Change of Use i <br /> Desc�ip�ion of Work(additional space provided on fha back): <br /> ��� <br /> Havo you startod working without a pertnit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATIOM PLUMBING PERMIT A€�PLICATION <br /> Typo of ProJocl: _Now_Atldn _Altoratlon_Ropair Type ol Projecl: _Naw_Addn _AlleraGon_Ropalr <br /> SAow Number(f)ol flxmres Show Numbar(pJ oI nxturos <br /> AIC—air handling units Toilet <br /> Forced air s slems Bathtub <br /> Gas piping Lava�ory(wash basin) <br /> 1 Waler healer � Shower <br /> � Gas fireplace � Kitchen sink&disposal <br /> Gas range / Dishwasher <br /> ; Clolhes dryer Clolhes washer <br /> Range hood Waler healer <br /> Exhausl(an Sink(service/barlmoplelc.) <br /> Heal pump BackFlow preventer <br /> Unit heater Urinal <br /> Doiler Drinking Founlain <br /> Refrigeration Floor drain <br /> Woodstove Grease irap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM other: � � <br /> Number of Heads Olher: u�, <br /> t� C� �,�,, /, iO- u, � <br /> I hereby cediiy Ihal I have read antl examined ihis application and know Ihe�samA lo De Irue and co ct.Au p�Ovisions of laws and ordinances goveming <br /> this lype ol v.ork will be complied wilh whelher specifed herein or not.The granling ol a permil does not presume to give authority lo violale or cancel <br /> ihe pm�ision ol any olher slale or local law regulating conslmclion or lhe peAormance ol consiruction.That I am authonzetl by Ihe owner ol l�is proper�y <br /> to perform Ihe v,o :for iicl pplicalion is made and I comply wilh Ihe S�ate CoNrac�ors Law 1827 RCW and 296200 WAC <br /> / ' <br /> ' / �Z- <br /> Owned t riz ed Apent Slgnaturo � ale (Revised 22011) <br />