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f <br /> PERMIT APPLI TION <br /> BUILDING/MECHANICALIPLUMBING SIG ISPRINKLERlDEMOLITION <br /> CITY OF EVERETT PE IT SEF<VICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everetlwa.org M <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM a '/ � <br /> SITEADDRESS: n•/O` L ` / � A� PROPERiYTAXII l J�SOO, PEf�M1T�1�_a, <br /> �, �a <br /> LEGAL for new construdion: Sho�PlaVsubCivision Lot No._ (ettech copy ol bnp lepal EeecMptlon) <br /> OWNER Q C�1�1� PhonHE-mall <br /> ad�e.6 3��i c� , �,� �ao� � �m�,s���z�, cc M RRrH's r �K F <br /> CONTRACTOR 1^ �4 k r L&I Lit.k / <br /> tldresa ,✓ere.} � �'�� PhonNEmeil !i�f — ,j�j'(O G <br /> 7ENANT B INESS NAME CONTACT FOR PERMIT <br /> �aN� PMne/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use ot Bullding L � g HEAT SOURCE: <br /> Proposed Use of Building ��'`�^P• Gas Electric Other <br /> 8uilding rype: _Single Family _Duplex_Townhouse _Multl-Femily _Compiercial <br /> Type ol proJecl: _New _Addition _Remodel _Repair_T.I._Sign}LSprinkler_DemolRton_Chenpe of Use <br /> Description of Work(addillonal space pontled on fhe 6ac1�: <br /> Z1�'K�l' '�u L�Gut S�6a1j i tuS'in -�'u b4��d (►+5. <br /> Have you started working without a permil7 _YES _NO <br /> MECNANICA�PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProJxL• _New_Addn _Alleration_Repalr TypeofProJect: _Naw_AAdn _Att�nlion_Repeir <br /> ShowNumDerfNJo//lafuros ShowNum6erM olflufuret <br /> WC—airhandlin units Toilot <br /> Forced air s stems Belhtub <br /> Gas i In Leveto wash basin <br /> Water heater Shower <br /> Ges fire lace Kitchen sinY,&dis osal <br /> Gas ran e Dishwasher <br /> Clolhes d er Clothes washer <br /> Ran e hood Water heeter '� <br /> [zhaust fen Sink(service/barlmo letc. � <br /> Heat um BackBow reventer <br /> Unit heeler Urinal <br /> Boiler Drinkin Fountein <br /> Refri eration Floor drain . <br /> Woodstove Grease tra <br /> � Ductin Rootdrains <br /> � Olher Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM I o�ner: <br /> Number of Heads I Other: <br /> I ereby etlity Iha 1 va read and ezamined I�is appliwtion and know Ihe same lo be irue and correct.All provisions of laws and oNinance�qoveminp <br /> t Is type f wrork wi complied wit�whether apeclfied hereln or not.Tha pranlinp ot e permil dcea not presuma to give authotlty to violete or cancel <br /> t pmvi lon ol an o er atale or Iocal law repulalinp consWclion a the pedormance of conaWdion.TTaI I am eulhorized Dy Ihe owner ol thls pmperry <br /> to erlor the wvrk r which epplicalion Is made anE 1 wmpiy wit�51ate�nlrectoro Lew 18.27 RCW end 288.200 WAC <br /> /9 <br /> � <br /> Owne lAuthoriz gent 5ignature D IC (ReWsed 7/1011) <br /> r�� <br />