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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8657—www.everettwa.org 2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM " N` � <br /> PftOPERiYTA%q PER ITJ( OLI _� <br /> SITE ADDRESS: S�� � �' .�� <br /> i � �l-c � U <br /> LEGAL for new wnstmction: Shod PlaVsubdivislon Lol No._ (atlach copy of long legal descnption) <br /> OWNER Phone/E-mail <br /> Address CitylStatelZip <br /> CONTRACTOR �lL �l yL0. c'U:{�S �T� L&I Llc.# ��L�F 5 �_ I.US C _ <br /> alw c- �o^"�c�r''x �-"'Wc z� �� Z PhonelEmailZ�""L{ g - 39 � ' <br /> Address Ci�7/ho�� �7 S l.�-S <br /> TENANT BUSINESS NAME C�TACT FQR PERMIT <br /> r<PfJ rt 2nc.�'� <br /> J�� JV�`�S Phone/E-mail 'lAb "L� � �1 — � � <br /> BUILDING PERMIT APPLICATION CON7RAC7PRICEOFwORK�OL�X7 � '� <br /> HEAT SOURCE: <br /> Existing Use of Building ' <br /> Proposed Use of Building Gas_ eiectnc__ Other_ <br /> Buildinglype: _SingleFamily _Duplez_Townhouse _Multi-FamilyK�Commercial . <br /> Typeofproject: _New _,Addition _Remodel _Repair_T.I.�Sign,_Sptink�er_Demolition_Change ofUse <br /> Deacription of Work(addifional space provided on fhe backJ: L� �� �-.T S��N � <br /> �NS-�(��.� 1 ll..l.JM� (� f���1� CAf <br /> r� �f��-'�--5 lt--S ��15Ttr-�-, ��'�`3� l�n,T <br /> Z •rt�!i��T ` ! <br /> Havo you started working without a permit7 _YES �rv V <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJect: _New_Addn _Alteratlon_Repalr TypeofProJect: _Nuw_Addn _Alteralion_Repair <br /> SAow Num6cr(#1 olllxfures Show Num6er(p)ol lirtures <br /> � A/C—airhandlingunits I Toilet <br /> � Ferced air systems I Bathtub <br /> � Gas pipin Lavalo (wash basin) <br /> � Waler heater Shower <br /> � Gas lireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood I Water hea�er <br /> Exhaust fan � Sink(service/bar/mop/etc. <br /> Heat pump � Backflow preventer <br /> Unit heater j Urinal <br /> Boiler Drinking Fountain <br /> ReGigeration Floor drain <br /> � Woodstove � Grease lrap <br /> ( Duclin Root6rains <br /> � Olher P.ledical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM � other: <br /> INum6er of Heads I Other. <br /> I hereby cerlify that I havo read and examined this application and knrnv the same to be tme and wrrec4 All provisions ot laws and ordinances goveming <br /> this type of work will b mplied vhth whether specifed hrrein or noL The granling al a permit tloes not pmsume to give authonry lo violate or wncel <br /> tho p�o � any herstate or local law regulating constructlon or Ihe pedormance of construction.That I am aulhonzed 6y Ihe axm_r of lhis properiy <br /> to orm th +ork r wh�ch application is maQe and I r,omply with tha State Conlreclurs Law 18.27 RCW and 298.200 WAC <br /> ���-'�� ���'�� <br /> OwnedAuthodzed Agent Signaturo Date (Revised 7/Y071) <br /> �(� <br />