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( � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, ✓VA 98201 -425-257-8810—FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO�PM o� "��'�(Z <br /> II!�I DRES : („ /��� �C PNOPER7YTA%N PERMIT � <br /> L� <br /> LEGAL for new constniclion: Short PleUsubtllvislan Lot No._ (attech copy ol bnp bpal desaiptlon) <br /> OVYNER PhondE-mail <br /> ddreea CNylStete/Zip <br /> CONTRACTOR��I,GCCd/� efY� � ' LGC L&I Lic.� � <br /> aareas//0/��/9� f. . 5�[d'-/G/�veie7l�i.ull`'7d' Od� Pn� men Q�8 t� e 'w.��„ <br /> TENANT BUSINE5S NAME Cq�ly�T FO� F�MI��_ <br /> _ � J C!!/�Lf� �Zo p� �y/�,'�y"��,���7 <br /> ��q,�Q '�0.MQe PhonelE-mail�.S 3� 27�DU `–�n�— – " e • OW�. <br /> BUILDIN6 PERMIT APPLICATION CON7RnC7PRICEOFwoRK <br /> Existing Use of Building �1l G Y� S il'- HEAT SOURCE: <br /> Proposed Use of Building Gas Eleciric OtRm <br /> Building type: _Single Family _Duplex_Towrihouse _Multi-Family _Commeroial <br /> Type of projed: _New _Addition _Remodel _Repeir_T.I._Sign_Sprinkler_Demolition_Change !o�f�Ua�9��J�".� <br /> Descfip�lon of Work(additionel space pravidetl ar fhe back/: W,Gl�k �µ Pj f�dl�j � 'C� r'u57""'--'� ' <br /> �'�s/.�a.1i� ,P.eF!e ��ra,(�u;n P�o�P"„ g��o b. <br /> s/�e� cR�� h�re�d .�v n�u/��� f°Nrsti� <br /> Have you atarted working without a permit7 �YES _NO <br /> MECNANICAL PERMIT AP LICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: __New_Addn _AlteraUon_Repelr Typa ol ProJac:: _Naw_Addn _AINnGon_Repalr - <br /> Show Number(M)oi flxfures Show Numbar(M)o/flaYures <br /> A/C–airhandlin �nits Toilet <br /> Forced eir s stems Bathtub <br /> Gas i in Lavato wesh basin <br /> Water heater Shower <br /> Gas fire lace Kilchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothas washer <br /> Ran e hood Water heatcr <br /> Exheust fan Sink servicelbar/mo letc. <br /> Heat um BackHov. revanter <br /> Unit heetar Ur(nal <br /> Boiler Drinkin Fountain <br /> Refri eration Floordrain <br /> Woodstove Greese tre <br /> Dudin Roof dra(ns <br /> Other Med(cal Gas <br /> SPRINKLER/SUPPRBSSION SYSTEM other: <br /> Number of Heads I Other: <br /> 1 hereCy certiy that I have read end ezamined Ihia applicatlon and knaw the aame to be lrue and cortect.Ali provisions of laws anG ordina�es yovemirp <br /> ihis type ol work will be complied wilh whether specified herein or not.lTe g�anling ol e permit dar.not presume to B��e autlwnty to vblata or cancN <br /> iho provision of any olher s�ate or Iaai law repulaling wnsimctlon or ihe parlomience of wnstmctlon.That I am autOMzed Dy lhe owner ol this poperty <br /> to pertorm the xork fo•which app�ication I metle an compty wilh the State Conlraclora Law 18.27 RCW anC 298.200 WAC <br /> � , a H„ i✓ �Z/�-^2� /Z , <br /> OwnerlA orizatl ge ura Date (ReWsetl7lt011) <br />