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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar S� . Everetl, W A 98201 - 426-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM /17 �//'—l' <br /> SITE ADDRESS: -� � 7ROPEaTV TA%p PERMIi M <br /> � �} Sr St. �'-( ,Y�< � - 51I � - L <br /> IEGAL�ur new construcuon Shnrt Plal'subdrvisiun Lot No (nitach copy of long legal descripl�on� <br /> OWNER � ^ 1 :-f{ ! {( '� f SS Phonv�F�mai� <br /> 4d�hess � �. . - �� CiIyl5lntclZiP � � �, L��7-' �J �t� <br /> CONTRACTOR � ' 'l I . .1 ��( + S L L 8 I L�c a i2 v1C' <br /> , �. �, � STn3 P�,��,�,E�,:,�� yzs�7 �i�s s°�� - <br /> n<mr�ss ��l C ' � T ; G�0 lL Ir C -�� r�lt <br /> TENANT BUSINESS AME CONTACT FOR PERMIT � L,� � <br /> ) 77lty��tS. l� <br /> � � 1 U� (��(! � . e(� ' 7( S Phnne'GmaJ � L-5 / 7l1�l 3) <br /> BUILDING PERMIT APPLICATION coNrRncr PRicE oF WORK _ __ _ <br /> Exisling Usc ol Ewldin9 HEAT SOURCE�. . <br /> Proposed Use ol Budding .. ._ G�s Electnc Olhr.r <br /> BwIA�n9 type�. _. . Smgle Family _. Duplex_. Townhouse ___ A1ullrFamily . Commercial <br /> Type ot pro�ecC _ . New .._AddAion _„_ Remodel __ Repav_ T I ,x Sign _Sprinklcr . Demoldion Change ol Usr. <br /> �CSf.fipli0�01 WOfk(nAAihnndl s(raco provrAr<I on Ihe UacFl: � <br /> �.�,� �I (( l.� Gi,�b� �� � C �-=�tC' S'%ti • <br /> Have you started working wllhoul a permit9 YES /� NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pro�ect: New AAdn Alleralion Repalr Type ol ProJect: Naw Addn Alteratlon Repalr <br /> Show Numbcr(NJ o!fikluros Show Numbcr(N)o!/i+Wms <br /> NC-air hlndlin Unds Toilet <br /> Forced air s slems Ralhtub <br /> Gas pipin Lavatory(wash basin) <br /> Water henler Showei <br /> Gas lueplac� � Kitchen sink 8 disposal <br /> Gas ran r Dishwashcr <br /> Ciolhes d er � Clothes washer <br /> Rdnqe hooA Water heater <br /> Ekhaust lan Sink(seroicelbadmo letc <br /> Heat pump Backllow reventer <br /> I Unil hrater Urinal <br /> � Boticr Dnnkin Founlain <br /> Relri cration Roor drain <br /> WouJ,t„vc Greasc tiap <br /> Ducling <br /> Roof dr�ins <br /> � Other Medical Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM otner. <br /> NumtmrolHcaAs Olher: <br /> i b��mby�eriJy Ih.�l I h,�vo ic:�d and u�mninad Ihu appLcdtwn anA know Iho sOme lo be iruo and eorrecl All prowsons ol laws anA ordinances govominq <br /> n���,ty-pi•nl wvnF will be�o�npbeJ va�h wtmthei specihoA herom ui not Tho praniing ol a pertnil do�s not preswne lo grvo aulhonty lo violate or cancel <br /> ii„�p���viswn ol any uthm slata or hxal law iegulauny construr,�iun rn Ihe P�`���mnnce ol conslmd�on That I am aulhonzed�y the owner ol lhls property <br /> i,�,�,��ib�nn t vm�M Im w1ud�app6ea6on Is maAc and I eomply wi�h the Stalc Conlracbrs Law 1B 27 RCW and 296 200 WAC <br /> ! , J � / <br /> Ow r/Autho xed f)Qe il Signature <br /> On u lRrvisea 1;2ut 1) I� <br />