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PEF�1�9�� APPLICATION <br /> BUILDING/MECHANICALIPLUMB�NGISIGV�ISPRINKLERlDEMOLITION <br /> CITY OF EVERET'.' PERMI7 SERVICES <br /> 3200 C dar St., Everett, WA 98201 -d25 25'-8810- FNX 425-257-8857 -www.everettwa.org <br /> .DD �JTM �g� TIONS ARE A�'EPTED FROM 8 AM TO M1 PM - � �) `� <br /> SITEAUDRESS: `� �� �,�-�� � e I (�� PROPERNTA%tl PE tdlTp <br /> _i.t�.e�--n-r �k.-�( 20 I - n? <br /> LEGAL�or ne���constmcbon Shod PlaVsubdrvisian Lol No_ (at:ach coay oi lo��a Irgal description) <br /> OWNER L (L Phone�E-mail 2.,�j -2.l0� - <br /> nCdress " GpL[f t, CitY%S;ate2ip �]�(7_� w)A `�g� <br /> CONTRPCTOR "EYV� _L81Lic.# I �Da� <br /> Atltlress Zp(o � $7 G P UPIC- U1A �i8� Z �'honeiEmaii 7,53- g�3- t218 <br /> TENANT BUSINESS NAME ' CONTACT FOR PERMI�f {��N DFIVIS <br /> l <br /> �Ra�l�DF.NC� +�aRv-!� <-tA�1� ano�erE-ma�i 7�53 -ZnZ-7ooG �12�:res� �weet. <br /> BUILDING PERMIT C�PPLICF:TION CONTRACT PRICE OF WORK �-7 aD,..D— � <br /> Existiny Use of Building 7AR—.' ' �'�'� r"Q II'�� �' HEAT SOURCE�. <br /> Preposed Use of Buildinq_ �� �� Gas__ Eleclnc_ Other_ <br /> Building type: _Sivgle Family _Duplex_Townhouse _MWti-Family �Commercial <br /> Type of projecP. _New _Addition _Rem�del _Repair_T.L_Sign�Sprinklzr_Demolition_Change of Use <br /> Descripho�'�of Work(atlddional space provideCon the back��. �e�-rV ti(� �n�s-f^1(,� L�/(�. L� �a..y sys�r� <br /> To ?Ro�/��E SP¢u•.+lcl C.�✓SR�c�� A,- New�y E,�L�-os�� PcD�"5-l3aPN Bwoc�E, <br /> Have you started working without a permit? _YES �NO <br /> MECHANICAL PERMIT APPLICATION � PLUMBING PERMIT APPLICATION <br /> Type ol ProjecC _New_AdUn _Alleration__Repair Type of ProjecL _New_Atldn _Alteration,_Repair <br /> Show Number(IX)of lixtures Show Num6er(H)o/(ixfures _ <br /> � AIC-air handlinq ur,.'�s ' Toilet <br /> Forced air systems I Bathtub <br /> Gas piping I Lavatory(wash basin) <br /> � Waler hea�er � Shower <br /> Gas fveplace I Kitchen smk&disposal <br /> � Gas renge ' Dishwasher <br /> i Clothes dryer I Clolhes washer <br /> Range hood I Wa?er heater <br /> li Exhausl fan I Sink(servicePoarlmoplelcJ <br /> � Heat pump � Backflow preventer <br /> Unit healar ' Urinal <br /> 8oiler Drinking Fountain <br /> Refngeration li Floordrain <br /> ��I Woodstove Grease Irap <br /> Ductin9 II Roof drains <br /> �' Oth2r � Medical Gas <br /> SPRINKLER I SUPPRFSSION SYSTEM I O�her <br /> 27i ' Nv�nber o(Heads I Olher: <br /> i��.,reDy cendy Ihat I hava reatl and exammetl lhis apphcaiion antl know lhe same to be Ime antl wrtett.All provisions of laws anU ordinances governmg <br /> ��his Iype ol v+urk vnll be compiietl w+th whe!her speafietl herem or not The gran�mg ol a permit tices not p�esume to give autho�dy to wola!r or cancel <br /> tne pmvision of any other st •or local law regulating con,tmction or Ihe pertormance ol consirur.lioa Tiiat I am aulhonzetl by R�e ov.r�er of Ihis prcperty <br /> io pertorm Ihe v,ork lor wh applic.lion is rnatle and 1 comply vnih Ihe Sla�e Conlraclors Law 18 27 RCW antl 296 200 WAC <br /> � � �v <br /> OwncrlAuihorizc A9enl5ignaturc <br /> Datn �Re'nsetl 2/207 7) <br /> i ��� <br />