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F�ERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES b�a� �I� <br /> 3200 Cedar St., [verett, WA 98201 -425-^_57-8810- FAX 425-257-8857-www.everettwa. g <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �QO.3 ^ <br /> ER Y T % E // <br /> � `� . DS / - -05 -vo3 - <br /> I Lot No.,_ (attach capy ol long legel de dptlon) <br /> IEGALIornewconsWclion�. ShmtPiaUsuhdlvislon_ -- <br /> OWNER/✓7jL,j� L� � O Phone/E-mail <br /> Address �� � � •�r AI� C�Iyl5lalelZip <br /> � D � L 8 I Lic.# <br /> CONTRACTOR � u'r f71S . <br /> � �� f'hunclCmail 7/S7 � 7 <br /> Addrese ' <br /> TENANT BUSINESS NAMC• CON T FOR P ,`�A1 „�0���LLJ_ <br /> �J��Cj' � <br /> /'/�T � +�IO /• � nc/E�mail y� �3�.'�N ��C� <br /> UILDING PERMiT APPLICATI C RACI.PRICE oF WORK . <br /> , �/ HEATSOURCE: <br /> Exisling Use of Building � ` <br /> Proposed Use of 3uilding�� I Ges Eiearic Other <br /> Building type: Sin�le Family _Duplez Townhouse __Multi-Family _Commercial <br /> Type of projecl: _New _Addilion _Remodcl Ra�alr�T.I._31gn_Sprinkle�D1emo�lilion�/ Chan e ot Uae <br /> Descfip�ir,n 1 Work(adJitional space �owde�Iho ba��y�� ,S.(L <br /> / �No ' ,�, � � �' iL <br /> ��/iAE ' / ' <br /> �(/m������Ej� •✓ /f7rlf!`o�l� � <br /> v�us aAeN�orhln�oul,(bc� t YES _NO�� � �c,J/(/{yc.� • • <br /> MECHANICAL PERMIT APPLICATION PLUM ING PERMIT APPLICATION <br /> Type of ProJocl: _Naw_Addn _All.'�etlon_ftopalr Typo ol PraJocl: Now_Addn _Altaration_Repelr <br /> ow Number(M)o!llrfurc� <br /> Show Number(M)o!fixfuref Toilet <br /> AIC–air handliny unds Bathtub <br /> Forced air s stems Lavato (wash basin <br /> Gas ipin Shower <br /> Waler heater Kitchen sink&dis osal <br /> Gasfre Iace Oishwasher <br /> Gas ran e � Clolhes washer <br /> Clolhes dr er � Water heater <br /> Ran e hood Sink(servicelbar/mo /elc) <br /> [ahaustlan BackOow preventer <br /> Heat pum Urinal <br /> UnA heater <br /> �rinkin Fountein <br /> Bo�ler F°loordrain _ <br /> Rehigerahon Grease lrap <br /> Woodstove <br /> Roof drains <br /> Uuclin Mr.dical Gas <br /> Otl�er — <br /> SPRINKLER I SUPPRESSION SYSTEM _ other <br /> Number ol Flends — <br /> I here6y cetlity Ihal I have read nnd examined Ihis application ond know tho same to be Irue end correcl.NI pwvislans ol laws and oid�nances 9overning <br /> this typa ol work wdl be complied with whether specifed here�,n or not.Tha granlin�ol a permil does nat presuma lo giva eulAonly lo vio�ate o�cancel <br /> Ihe p�ovision ot airy oiher slnlo or local law reg��t�ling consiruction or Ihe performance ul conslmction.The�I am authotlzed Ey�he ow�er ol lhis property <br /> �o woik lor whid�aVphcation is made and I comply wi�h tho S�ata Conlraclors Law 1B 27 RCW end 298 200 WAC <br /> Vr— � v' /� <br /> �.vner/Aulhorlmd nt Sly uro � <br /> .,�te (Revisetl 12i20101 <br />