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PERMIT APPLICATION <br /> BUILDINGlMECHANICAL/PLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE AP�RESS: vaovearr rnu� PERMIT R <br /> :=�8 C ��nn � — OU �. � . �'1 C:� J � 3 <br /> LEGAL lor new conslmabn�. Short PWUsuhdrv¢wn Lol No._ (atlaU�wpy ol brq kpal desaqlan) <br /> OWNER ->� � a�o�,e-��� N�5 �asa- s-. <br /> Addresz City�Slalc/Zip <br /> CONTRACTOR - = a L 8 I Lic.k C�H=�Li <br /> �L �'X t oQ� . .� PMno�Erreil < _ _ t� <br /> Adeross I -- - j - . <br /> ENANT BUSI SS NA E CONTACi FOR PERMIT <br /> i --,.- — D P i.r'2'c�.� l.l��=��+au c iZ <br /> j�-{E STUR r_l�10.;:>,_ <br /> /V1 /_ '- •� - -c ' .. �� Phorro/E-rtuil �Q - , - 11GU <br /> BUILDING �ERMITAPPLICATION CONTruCTrRiCEOFWORK IG oCs, �O <br /> Existing Use o�Building ��i"O�"" "T ���i`n �' �'-`^ "� HFJ1T SOURCE- <br /> Proposed Use ut Building �TL�t--i� � �H./D �Gbn'I_S Gas_ Eleanc O�hor <br /> Oullding lype: Single Family _Duplex_Townfwuse _Multi-Family �Commercial <br /> Type ol project_New _Adddion _Remodel _Repair�TJ._Slgn_Sprmkler_Demdition_ Change of Use <br /> DeSc�iptio0 0(Wo�k(edd�ronel spete P'�vded an the beck)�. � �_ <br /> `�-� <br /> }Y�'OV.i-�'� �'Ei,i,-E.�..A�.i.G!f��'Z /_'�niy:? � ic�aC;.�C c I�.U6 M;� , '1'�J. : 11 <br /> iU, i � , 20 �ts �?(�, �39 .3�� , <br /> 3` <br /> Have you staAed wor�Cing without a petmit� _YES �NO <br /> MECHANICAL PERMIT APPLICATION PIUMBING PERMIT APPI�ICATION <br /> TypeolPmjecl: �New_�ddn _Atleration_Repair TypeolProject: _New_AdAn _Atteralian_Repair <br /> Show Numtxr(M)o/firrurns Show Number(MJ ol Bxfures <br /> A/C -air hard�l units Toilel <br /> Porced air s stems BatMub <br /> Gas piping lavator (wash basin) <br /> Water heater Shower <br /> Gas fire larn Kdchen sink 8 dis sal <br /> Gas ra e Dishwasher <br /> Clolhes diyer Cbihes washer <br /> Ra e hood Waler heater <br /> Exhaust lan Sink semcelbadmo letc.) <br /> Hea1 pum Backllow reverder <br /> Und heater Urinal <br /> Boiler Dnnki Fountain <br /> Rehi eration Floor d!ain <br /> ������Ve Grease tra <br /> Dudin Roof Arains <br /> Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other <br /> Number of Heads Other. <br /> I hereby ceridy ihat I haw read and examned tAis appl�otron and knowlhe samo to be bue a�d cortecl.N povisrons o�laws arM ordinanws governng <br /> f�n Npo ol v.oik v�ll be comp6ed Hith�+hclher spedlcd herem or rot.The Brantng ol a pemN Aoes rwt presumo to prve auVwriry to vlolate or ca�cel <br /> the pmvision ol any other state or bwl Wwwgul�tug construction or Ihe peAormance oi constmclbn.Tiu�I am aWhor¢ed by ihe owner of lhis poperty <br /> to ocdof�hF v.ork lor�+hlch applicalion Is madc and I comply wM ihc Stale Contradors Ww 1827 RCW arM 296200 WAC <br /> !-. . i /� :.�� v�/U�Y+/ � <br /> OwnedA�dhorized AgeM Signature Dam (Remsetl 2�20111 <br /> IL <br />