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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St.,Everett, WA 982.01 -425-257-8810-FAX 425-257-8857--www.everett►va.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEAQDRI"iSS• PROr'[NTY Trix tf r'[R•.1iT <br /> .1110�Ljjp►�7al ;a)E �W agi5Si 7")/°1? AA1LI - O 12 Z <br /> LEGAL for row constructnn. c , .r —Lot Nn (,attach tory el I ;8-3a1 dasuip!ic�) <br /> OWNER .-5u1c✓AtAlr'1 +4 LttJtu(; '1t2v0Plxxie.E•mad <br /> P.D. 7xr00 J� Gty1Statezp /'y1At'�(t�cut!/� . 0.)A 9`a 2-70 <br /> CONTRACTOR 'VCIr �?1 t,. Tl . 1_.t Mr,1-11 L Si I Lir.# EVE1 C?20-1-. <br /> ..1,., 2i 1' C I -X. Vcr, .flat L 5 Z 2 31 IA <br /> TENANT BUSINESS NAME CONTACT FOR Pl_RMIT n'7AttlL e ax/WA• <br /> G.-- <br /> e.q ct I�:. r'013 Anti ,���� �(ìç-212 '3(, cin <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK . . OO <br /> Existing Use of Building__-,I` � CNi�+t,)t r HEAT SOURCE: <br /> Proposed Use of Building . 0 CHAD,G` trCGtric Other <br /> Building type: _Single Family _Duplex Townhouse Mutll.Fami!y __?.c Commercial <br /> Type of project: _New _Addition remodel is Repair_T.I._Sign_Sprinkler_Derro'iii:n_Change of Use <br /> Descriptiun of Work(edition/0 space provided al the back): <br /> fits:Attu_ c P-Nace <br /> H:we you started working without a pr:rmit? _YES _'L NO <br /> MECHANICAL PERMGT APPLICATION PLUMBING PERMIT APPLICATION <br /> Tyro d I Project• New—Addn Alteration tt�r.i r Typo of Project: New—Addn Alteration Repa.r <br /> Show Number(x)of fixtures Number(s)of fixture <br /> /VC-air handling unit,: Toilet <br /> 1 Forced air systems Bathtub <br /> Gas p'pinrg Lavatory(wash basin) <br /> Wat'.r heater --- Shower <br /> Gaa fireplace Kitchen sink 8 disposal <br /> Gas range _ Dishwasher •- ------- <br /> Clothes dryer Clothes wry h •r <br /> Hangohoof _ Water t;,,,it. i <br /> Exhaust fan I Sink(scrviceibarlmop!etc.) <br /> Heat pump _--_-- 1 Backrow preventer <br /> Unit heater I Urinal <br /> Beller I Drink,^n Fountain <br /> Refrigernt i i _ � I loot.:r.,ti <br /> Woodstovo I Grear..,Itap <br /> Ductuli,) I Roof rptri <br /> C7!hrr <br /> Medici-4( ls <br /> SPRINKLER I SUPPRESSION SYSTEM Other. <br /> Number of Heads I Other <br /> ;hereby certify that I ha%e read and examined this.;:t +'.fun arJ know ft • •.,lobe trim and correct.AU prcv!sion;ul laws arid ordinances governr <br /> this typo of work wet be complied with wfiether spoi.,l. .1 heroin or not.i h • i ru 3 of a permit does not presume to gkre authority to violate or canr.,:l <br /> the provision of any other stale or local taw regulating construction or the performance of construcllon.That I am auttn,rizel by the owner of this property <br /> to t...•f,. the work for which application is made and I comply with the State/Ccntrac ors Law 18.27 RCW and 296.20)WAC <br /> I <br /> Win, ori: 1 Agent Signature [iiia (Revised 22011) <br /> 1 I <br /> -/1/ <br />