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RERMIT APPLICATION <br /> BUILDING/MEGHANICAL/PLUNiBIN�/SIGWISPRINKLER/DE�rIOLITION <br /> CITY OF EVF�ETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 wvnri.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM �� "��' <br /> SITE ADDRESS: � PROPERTYTA%p PERMITtt <br /> I(71 � `� C v�v,; r.•a,. l��} � t! Z OG� ,L� Oc' — G'7 <br /> LEGAL`or new consW�tion: ShoA Pla7subdlvision Lot No._ (anach copy of long legal descnption) <br /> OWNER � �'�c ,nv���5 - I� ' �'- Phone/E-mailEC4'SH�� I'.70}/Ghr.�,SK�.�+<m�'�-ll .c���li <br /> Address 1���.� ��w��G. �i . '��v.,�C. I�'o h CitylStaleJZip �I I�15.�5,�0 I <br /> APPLICANT: Ovmer xOwner'sAgent Conuactor ContrectofsAgent Tenanllm�s�w�a�ram"�^HM1O^1tl1BOv"""�oao..on��mosw�l <br /> CONTRACTOR T G �J L&I Lic.# COE 6us. Lic.# <br /> Address PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT if ��I <br /> _T1�= `-���5- 53�� <br /> � - �" IeN�-L� 1_ ,��,� � 1 ' <br /> PhoneJE-m:.il . �1.P.'`�-, � .�"C,'C e , �c;Y�'� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK�' � ��v�'�' <br /> Existing Use oF Suilding <<' �1 v-�• i�y'�i��� c -���f'��"= _ HEAT SOURCE: <br /> Proposed Use of Building�r• - �i� � °t c-C �r�r-+-`� Gas_ Eiectric� Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family K Commerciai <br /> T of ro'ect: New Addition Remodel Re air T.I. Si n S rinkler Demolilion Chan e of Use <br /> DESCRIPTIONOFWORK(adda�ona�spacepmvidedcnfheback): � �� � I' ,G � S �,H,y s��: <br /> S�ti-r�� , �-t......_(�;. ,c � � � <br /> ����v�� Cm,�.V• c�'��o�,z � <br /> MECFIANICAL PERMIT APPLIC/LTION PLUMBING PERMIT APPLICATION <br /> TypaofProjer.l: _New_Addn _Alteralian_Repair TypoofProjecl: _New_Addn _Alleration_Repair <br /> Show Number(#)o/�irturcs Show Number(#)ol�xtures <br /> AIC-airhandlin units � Toilel <br /> � Forced air s slems Bathlub <br /> Gas pipin y ' Lavato (wash basin) <br /> � Waler heater � Shower <br /> � Gas fireplace �� Kilchen sinR 8 disposal _� <br /> � Gas ran e � Dishwasher <br /> � Clothes d er � Clothes washer <br /> � Ran e hood / Water heater <br /> � Exhaus[fan 3 Sink(service/bar/mo /etc.) <br /> hleat pum Backflow preventer <br /> � Unit heater � Urinal <br /> � Boiler Crinkin Fountain <br /> — Refri erelion Floordrain <br /> � Woodstove Grease Irap <br /> � Ductin � Roof drains <br /> '� Olher �� Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM other: <br /> Number of Heads Other: <br /> I here�y cert0y Nat I ha+e reoC and a�amined Ihic epP���Kn anE know Ne wme to be Irue anG mrteC.N�pmvisions ol laws and oNinanms goveming N�s rypa ot wort:wil0o mmp6M <br /> vnt�who�her r.peafieA hemin or noL TTa praning al a Darmil exs nol pn�sume lo giva authorrty to violaio or cancel t�e pmvison ol any ot�er sla!e or loo�law m9uNtin8�nsV�dion <br /> TTat I "a7i C.onx�d Gy t�a oxner :pe�1y�o perMrm Ne work�or whid�appliratlon s ma0a anE I comply n+th Na Slaln Conlractors Law 18 27 RC W and 206.2iqA WAC_ <br /> �"�� `� I �� <br /> � n <br /> ��`"� ��� �''r 1� —! CC�r� (Revised&2072) � <br /> Ownefl �rihorizedAgentSignamre Date <br /> � <br /> 1 ' <br />