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� <br />u <br />� <br />PERMIT APPLICATION <br />BU��DING/MECHANICALIPLUMBING/SICNISPRINKLER/DEMOLITION <br />ClTY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everetl, WA 98201 - 425-257-8810 - FAX 425-257-8857 - www evCerettwa �rg -7 <br />APPLICATIONS ARE AC�EPTED FROM 8 AM TO 4 PM v�� y� C/ <br />ADDRESS: �'"j� -� <br />L'crnevieorslmction S�on <br />3i <br />PRO ER7Y TAX q PER�d1T # <br />,,,�r� L�v�l� oo�l UL� oo g W I2OS- <br />� Lo� ?Jo _ (allach copy ol long legal tlesa�pl�on) <br />-r Phonc/E-ma�l L�Z ) �� �7j 6 � Z 3 � � <br />C�IvlStalc/Zip �� Y(..k � � I, �/� � r� O U�-- <br />BUILDIhG PERMIT APPLICATION <br />Ex�sl.ng U5e c( Bu�'d.ng <br />LEILic # <br />�honc!Email <br />CONTACTFORPERMIT f1_.� �ti,,�„z„� <br />�,.�. <br />Phonzl"c-maJ �iZ� - 23k -L32� <br />CONTRACT PRICE OF WORK _ <br />HEATSOURCE- <br />ProposedUseol i in ��S'v�Y-f�°�'14Y -��� �— I Ga, _ eiec�nc omer_ <br />Budding type� �_ Single FamiP _ Dup!ex _To�vnhouse _ Multi-Family _ Commercal <br />Type of projecf. _ New _ Adtl�tion _ Remodel _ R^eparc �TJ. _ Sign 5(p/ rmkler� D�emol�t�on_Change o( Use � <br />Descrip!ion of Woik (add�uenai scace prov;Cad or, �he oack� ,(�, Ip(T e `.--,7�d.' S 1 LVI � I/p�-I �'-�� ✓` <br />�S-�,�Cir��e.��rfZ�- ��-c.��.�c��� , � �e��,4ae cQ+�ib�:cQr� �t9-/ �,.���,z-�J <br />c <br />Havc you started working without a permit7 YES _NO � <br />MECHANICAL PERMIT APPLICATIDN <br />of ProjecC _New_Addn _Alteralion _Repair <br />ShowNumOer(qf o//ixtum; <br />I NC - dR handhny uNts <br />Gas rar <br />Clolhes <br />lan <br />nmi <br />� Other __ <br />SPRINKLER I SUPPRESSION SYSTEM <br />PLUMBING PERMIT APPLICATIC�N <br />o( Projecl: _ New _Addn _Allera�ion _Repair <br />Show Numbcr (a) ol G+fures <br />K�tchen smk 3 dis <br />Dishwasher <br />Clo�hes v+asher <br />Water heater <br />Sink (service�barA <br />Backflo�v preveNc <br />Unnal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other <br />�• <br />' I Number of Heads I I I �mer: � <br />I hereny certity Ihat I have read and ezamined Ihis appUca;mn ,:• U knori Ihe same to �e Irue antl correct. All provisions of la�vs and ordinances govermng <br />Ih6 �ype ol work vnll be comphetl wdh whether spenfiea herein or nol 7he grantiny ol a permit daes not p�esume lo give aWhority to violale or cancel <br />U�e provision ol any olher stale or local law regulaling conslmc�ion or I�e pedormance of conSlruc�ion 7ha1 I am aulhorized 6y th^ owner of this pmperty <br />Io nertorm Ihe w or v+hich appiicalion is made and I comply wuh �he State Conlrac�ors Lavi 1827 RCW antl 2°6 200 4VAC <br />`�• � Z(�' �� �(L <br />OwnedAuU�oriz dAqentSipnature D��e '�Q�`"-"`1'�"���1 <br />