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PERMIT APPLICATION <br /> BUILD;NGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM'i O 4 PM <br /> �ROPE N TAI(N PERMIT N <br /> SITEADDRESS: D/\ ��'M- �� ����'�i4.]�L4� o I o � - a2e <br /> V <br /> LEGAL lor new constmctlon: Short P�aUsubdivislon Lo�No._ (auach copy of long legal tlescriptlon) <br /> OWNER �'hOv, -�i�i��i . l"iN 1`� .1�� Phone/E•mall <br /> AdJress � U O�� ClrylStalelZlp ������ � �N � GI �`^''� V`� <br /> CONTRACTOR I � � � �N Ce����-N LI:ILic.# IjVTZ�� C��US� <br /> �-� 1A� i G /{ ^ <br /> AdOress <br /> �� li�� �\_ . 'V�el � :���� Phone/Email �.( � . ) . -1 L'U <br /> TENANT BUSINESS NAME CONTACT FUR PER�AIT 1� N�,`�l'N <br /> J <br /> uV�� N ti � <br /> Fhone/[-mal �)�r'� 1 �/U� 7�'�� Q1�.1 L�.L� � ZYAII%�1i 1 CCH <br /> @UILDING PERMIT APPLICATION CONTFL4CT PRICE OF_WORK ' � `� �'� <br /> HEAT SOURCE: <br /> Exisling Use of Building �, ` `' r y <br /> ProposedUseo(BuildingM�1`v 5�� 1�%� V\J � •� Gas_ eiearic__ Omer_ <br /> Building rype: Sin91e Family _Duplex Townhouse _IAutli-Family �Commercial <br /> TypeofproJecl: _Nevr _Addition _Remodel ._Repalr�.�T.l._Sign_Sprinkler_Demolition_Change otUee <br /> DescriplionofWork(aAhi�ionalsac�prvidodonlhebackl: � � O ,pcSUG'� �v�r�un,�._,,, <br /> 1�11�'��� (.�l) V �I �i�^��5 , ��� E� ��v�,'S� � 1� �rN �,� rt�, <br /> 4 \71E'k�`;�� I�GP- Pl,r1N � <br /> Have you startod working withou[a permit4 _YES ,�NO <br /> MECHANICAL PERMIT APPLICATION �rWMBING �ERMIT �?PLICfiTION <br /> Typo 01 ProJecl: _New_Addn �Alteretlon_Repair Typu at ProJect: _New_Addn _Alterotion_Repalr <br /> Show Numbcr(k)o/flxtures Show Number(A/olflntwes <br /> A/C-airhandlin units Toilot <br /> Forced air s stems � BaUilub <br /> Gas Dloin Lavatory(:•+ash basin) <br /> Waler heater Shower <br /> Gas fireplace Kitchen sink&dis osal <br /> Gas ranqe Dishwasher <br /> Clothes tl er Clotl�ss washer <br /> Ranqe hood Water heater <br /> Exnausl fan Sink(servicefber/mop�elcJ <br /> Heat pump 8ackflotiv preventer <br /> Unit heater Udnal <br /> � Boiler Drinkinq Fountain <br /> Re(riQeration Floor drain <br /> Woodslove Grease irep <br /> Ductin Roof drains <br /> Other tdedical Gas <br /> SPRINKLER I SUPi�R�SSION SYSI'EM Other: <br /> Number of Heads Olher. <br /> I hereby cehity Ihal 1 have read antl eaamine0lnis applicntion nntl know Ihe same to be lme and corted.All N^-�ici�ns o;lav5 and ordinances goveming <br /> Viis lype ol work vnll�e comolled H11h wl:elher specifed herein or not.The granling of a permil does nol presuma lo give autho�iry to violate or cancel <br /> Ihe provision o(any other sla�u or local law requlaling consln�ction or�ho peAormance of construclion.That I am authorized by ihe ovmer of Ihis proOeM1y <br /> to pertorm lho work im which a plicaGon Is made and I comply with lhe Slala Contractors Law 10.27 RCW and 296200 WAC <br /> ( _ ,.,�- r �i �„ 5 ll 21 I i ,Ro�,Sad�o,,, <br /> Ownedq @iod¢etl U Ipnawre �'1z <br /> l/ �2 <br /> � <br />