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( <br /> PERMIT APPLICATION � <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98207 -425-257-8810—FAX 425-257-8857—www.evereKltwa.orqL +t� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM J ��D <br /> SITEADDRESS: PROPERiYTAXp P RMITR � <br /> � <br /> LEGAL for new construction: Short PlaVsubdivision Lot No._ (attadi copy of long legal description) <br /> � <br /> OWNER Jn+� hone/E-mail L — 2 - � <br /> ,,,e,s 6 oZ � CitylStalGZip <br /> CONTRACTOR e �L 181Uc.# � <br /> Addrcss <br /> s� Z Phone/Email G <br /> TENANT BUSINESS NAME CONTACT FO PE MIT <br /> �� s�-dn�-.3y�t� <br /> � � � �"�� PhonoJE•mall 7.7�-�5 p- <br /> BUILDINGPERMITAPPLICATION CONTRAC7PRICEOFWORK � 'n <br /> Exisling Use of Buitding S HEAT SOURCE: <br /> Proposed Use of Buiiding �� WF--- ca Electric Otner <br /> Buildingtype: _SingleFami�y _uuplex Townhouse _Mu1ti-Family ,�Commercial <br /> Type of project: _New _Addition �Remodel _Repair_T.I._Sign_Sprinkier_Demolition,_Change of Use <br /> Desaiption of Work(atlCilional space providetl on Ihe back)� <br /> Si..5�C1 �'r}95$ �-.x..i�c �tN <br /> Have you started working without a permil9 _YES NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa oi ProJect: _New_Atldn _Altcratlon_Repelr Type of Project: _New_Addn _Alteration_Repalr <br /> Show Number(Mi al llxfures Show N�m6e�(A)al IA1ures <br /> AIC-air handling unils Toi�el <br /> Forcedairs stems Bathtub <br /> Gas i in Lavato wash basin <br /> � Water heater I Shower <br /> � Gas fre lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> - Clotfiesd er Ciotheswasher <br /> Range hood Water heater <br /> Exhausl fan Sink service/barlmo /elc. <br /> Heat um Back9ow reventer <br /> Unit heater Urinal <br /> �oiler Drinkln Fountain <br /> Refri eralion Floordrain <br /> Woodstova Grease lra <br /> Ductin Roof drains <br /> � Olher Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: Qp,p d' i�,s,t��1a��.•�_ <br /> Number of Heads Other. <br /> I hereby certiy thal I have reatl and eMamined Ihis applicalion end know lhe same to be Iruo a�N cortect.All provisions ol laws and or0inance�goveming <br /> Ihis rype ol work will be complied wlh whet�er specified hereln or noL The granting ol a permit doee not presume to qive authonty lo violale w cancel <br /> the pmvision ol an Iher state or Iocai law repulaling constiuctlon or the pedormance of construclion.That 1 am authodzed by lhe owner ot this property <br /> to pe rm the k f �ch application Is made and 1 compty with the State Conl2ctore Law 78.27 RCW antl 298.200 WAC <br /> �(,�.t � S�1)�7s( 2, <br /> erlAuthodzed ASenl Signature Dale (ReWsed 7/7of 1J <br /> l � <br />