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FERMIT APPLICATION <br /> BUILDINGIMECHANI(�ALIPLUMBIMGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 - 425-257-8810—FAX 425-257-885�—www.everettwa.org <br /> qPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: —7 � � PROPERTY TAX p �RNIT# ��`/ <br /> � /CJU /J� � � <br /> LEGAL for new conslmction: Shotl PlaVsubdivision Lot No._ (attach copy of lon9 legal description) <br /> OWNER Pn�l CE � �A�/i A ALi�o 3 PhonelE-mail Q� .2 �-45S.i �dd��.' «tiob 6� proJ�c�epci. e(', <br /> Address /,3�/ �o� � fn/� Ci�y151ate/Zip E��� (rJA 9���� <br /> CONTRACTOR I�IFFh u i� 13 � Si'R�I�r��ZS L&I Lic.# 1�1Al�GB�'_C (o l�f� <br /> Address 3C 3��� ,1����'��ti' 4�EGCl i F�t?��. �� `l.r�%�' Phone/Email ,3'c+0 - �,34- �UC� <br /> TENANT BUSINESS NAMEP('R1L's Cou3y "f�=r'�— CONTACT FOR PERMIT �I��KE �Y/c�_„J,J�y <br /> L�z,�c—t•it�� �_-T_i �o�,JJ �� isn�I< 7r /� PhonelE-mail 3�o� 'ol-9?l�i n1mcl�nneJi�c�I�n . C.ertt <br /> BUILDING PERMIT APPlICATIaN CONTRnCr PRICE oF woRK _ <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Bu�;ding Gas_ Eleciric_ Other_ <br /> Building lype: _Single Family _Duplex__Townhouse _Multi-Family _Commercial <br /> Type of project: _Ne�v _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Descriplion o(Work(add�honal space provided on(he Gack�: <br /> Have you startec�worki�9 without a permit? _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Pro�ecC _New_Addn _Alteratlon_Rapair Typo ot ProJech _Nuw_Addn _Alteratlon_Ropair <br /> Show Number(N)of lixtures Show Numbcr(N)ol/iztures <br /> � A/C-air handling unils I Toilet <br /> � Forced air syslems Bathlub <br /> � Gas piping � Lavatory(wa;h 6asin) <br /> � Water heater I Shower <br /> Gas freplace I Kilchen s�nk 8 disposal <br /> � Gas range Dishwasher <br /> � Clothes dryer � Clolhes washer <br /> � Range hood � Wa�er heater <br />� Exhausl fan � Sink(service/badmop/elc.) <br /> hleat pump � Backflow preventer <br /> Uni�heater Urinal <br />� Boiler � Drinking Fountain <br /> � Refrigeration Floor drair /i.-�._ 5; rr,� r i 7 <br /> � Woodstove � Grease irap <br /> Duding Roof drains <br />�I I Other � Medical Gas <br /> SPRiNKLER / SUPPRESSION SY5TEM 5� Z I Other. ��,iy�� �/Jk=T�iCo��1� <br /> Numberoflieads StDE I Other: (;�,�;eqCr cf�=- 'T �F <br />� 1Gr1T �o E'/�5n��v Prl'AL. <br /> I hereby certi(y ihat I have read and examined lhis applicotion and know the same to be true and wrrect.All provisions of laws and ordinances 9oveming <br /> ihis type of work v�ill be complietl with v�helher specifed herein or nol.Tho granliog oi a permit does not presume to give authority to violafe or cancel <br /> ihe provision of y olher slale or cal law regulating constmction or the performance of constmction.That I am authorized hy the owner of Ihis propetly <br /> to perforrn�h vofk for which a lica�ion is made and I comply with!he State Coniractors Law 1827 RCW and 296.200 WAC <br /> ✓,-���! ���--7 �/,-�� �� <br /> Owne�uthodzod Ayont Signatu �����e (RevisedYt017) ` /� <br /> �� <br />