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PERMIT APPLICATION <br /> 3UILDING/MECHANICALlPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwpa.o�rgO <br /> APPLICATIONS ARE ACCLPTED FROM 8 AM TO 4 PM p 1 `�2 <br /> SITEADDRESS: PROPERTYTA%p PE MIT# <br /> I�,�-I CUIb.� /�iP �bU'�I � J�I . ; •: 12 —0(�I <br /> LEGAL lor new ronsimction�. Short PlaUsubArvision Lot No._ (altach c�py ol long legal descrip�ion) <br /> OWNER l2(��I�IYn� L�� ���I Cl ( ' . PhonelE-mail V� I � <br /> Adaress `��(1� �n�.11�� Q CitylStale/Zi;. �� V�J' rrS�C ` <br /> CONTRACTOR I 'l�l-l�SC�M 1 L&I Lic.# � U�I- �,D ��- U I <br /> Address Ic�a-� �"cl ��V�f� IJ � Il.ir'�1��� L1J/`� `1;f�U�:�- anoneiemai� �.�55� ��110� 5��� <br /> 7ENANT BUSINESS NAME K� Cp_��(^`.f-� CONTACT FOR FERMIT C'L��fS�� �,((�?Q��S <br /> ���(jJ i�i1Y���V' fr K�'I��l� lX�l l�i""' Phone/F-mail �.�5� J "���� ' S�� � <br /> BUILDING PERMIT APPUCATION CONTRACT PRICE oF wORK A' la �n�U"— �FSO�; ct� <br /> Existing Use of 8uilding HEAT SOURCE: <br /> Proposed Use of Building Gas__ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Spiinkler_Demolition_Change of Use <br /> Descriplion of Work(additional space provided on the back): <br /> Have you started working without a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Pmject: _New_Addn �Alteration_Repair Type of ProjecF. _New_Addn�Alteration_Repair <br /> Show Number(d)o//ixlures Show Number(q)aI�xtum� <br /> � AIC-auhandlingunits � Toilet <br /> Forced air s stems �athWb <br /> Gas piping � Lavatory(wash basin) <br /> � Water heater � Shower <br /> Gas freplace � Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clothes dryer � Clothes washer <br /> Range hood Water heater <br /> � Exhaust(an I Sink(service/barlmop/elc.) <br /> Heat pump � Back(low preventer <br /> Unil heater I Urinal <br /> Boiler Drinkin Founlain <br /> RefriSeration i Floordrain <br /> � Woodstove I Grease Irap <br /> � Ducling I Roo!drains <br /> � � Glher -�� I Pdedical Gas <br /> SPRINKLER � �UPPRESSION SYSTEM I Uther: <br /> � Number of Fleads I Other: <br /> I nereby certify that I have read and examined��is applica�ion and know ihe same to be true and mrrect.All provisions ol laws and ordinanms govermng <br /> uvs lype of�.wrk will be wmplied vntl�whether specihetl hcrein or noL The granling of a permit does not presume lo give aulnoriiy to viola�e or cancel <br /> th�:provision of any o�her state or local law regulaling construction or the peAormance of wnsimclioa Thal I am authodzed by the o�mer of Ihis property � <br /> n;porform Ihe work Inr which apphcation is made and I comFly wilh�he Sta�e ConVectors Law 1827 RCW and 296200 WAC <br /> �1 ,�� l//)i _Z ���� <br /> ,:r ,�,�� „��; - �I� I� �- <br /> Ov+nrdAu�horized A9ent Signaluro Date (Rewsed 2Q071) <br />