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PERMIT AF�PLICATION <br /> BUILDINGIMECH�4NICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32;0 Cedar St., Ever�tf, WA 98201 -425-257-8810—FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEAODRESS: PROPERIYTAXq �ERMIT� I\ �l� <br /> ��\� ,� �-^t� . i ii <br /> LEGAI'or new constmelion: Shod Plal/subdivision _Lot No._ (attach copy of lon�legal description) <br /> PhonelE-mail C. 2 ` - � � <br /> OWNER C.CC'��t'. �,t. \ 1 . �' . <br /> Address �� LlC2 p \ A.9..�4. Ciry/StatNZip � � ° ii ZU�? <br /> CONTRACTOR C} U� �n iU L 81 Lic.# C:.CC � l.�' <br /> [� CNt-C\Y�v�U�� � <br /> Address C-U �7J(- 'Z�OZ� \ US:�J�1 �'lV1U')b PhanelEmail L1� (�� n 1 ' t=c�Y. ��1 � �=� <br /> � TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ChYZ``v �to�(�U�_ . <br /> G�v`n���i°.. �4U\��l\ � Phonel6mail z0 •S30 <br /> BUILDING PERMIT APPLI�ATION CONTRACTPRICEOf WORK <br /> (� ��1. Zy <br /> Exisling Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Buildirgrype: _SingleFamily _Duplez_Townhouse _Multi-Family �Commercia� . <br /> Type of projecl: _New _Addition �Remodei _Repair_T.I._Sign_Sprinkler._Demolilion_Change of Use <br /> Description o(Work(atldifional space provided on the back): <br /> �N'=t�-\1 �� .M����.%O(�-,�\ 1-)JC� 1.a�» ii.r� Ly�aC����wvv � 14i ��-G `��VS �tJ <br /> ���\ S.�S�l..._ 41.� ±4'�y�:*LI u.� �.4-w.w� wc�'f`�2vc�'tVf �4:�"`^ ' <br /> � U., � �LL� fJN CW<�C OGrO,i� <br /> Have you started work(ng without a perm'�t?�,_YES ✓NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProJecl: _New_Addn _Alteratlon_Repair TypoofProjecl: _New_Ad�in _Alteratlon_ftepalr <br /> Snow Number(d)o!Iixtures Show Number f.,)o!Rxtures <br /> � NC-airhandlingunits � Toilet <br /> � Forced air systems � Balhtub <br /> Gas piping Lavatory(wash basin) <br /> � Water heater � Shower <br /> � Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothesdryer � Cbtheswasher <br /> Range hood Water heater <br /> I Exhaust fan � Sink(service/badmop/eta) <br /> Heat pump � BackBow prevenler <br /> � Unit heater � Urinal <br /> Boiler �rinking Fountain <br /> � f. � Refrigeretion Floordrain <br /> � Nloodstove Grease Irap <br /> � Ducting Roof drains <br /> �I � Other _ Medical Gas <br /> SPRIPIKLER/ SUFPRESSION SYSTEM I Other: <br /> � NumbcrofHeads I Olher: <br /> I hereby cetliry lhat I have read and ezamined this application and know tho same to be true and correcl.All pwvisirns of laws and ortlinances goveming <br /> Ihis rype of work will be complied�Nth whether specifed hemin or not.The grantin�of a permit does nol presume to give authority lo violate or ancel <br /> the provision ol any other stale or local law regulating constructlon or lhe pertormance of consWction.That i am authorized by�he owner ol lhis property <br /> iq FeAorm Ihe�rork�t)r which application is made and I wmply�Nth Ihe State Contractors Law 1827 ftCW and 298200 WAC <br /> / i l <br /> \� l�\ �-- �ICi 1 Zpi L - (Revised 7/2017J <br /> OwnedAulhodmd Agent SignaWro Dafe <br />