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PERMfT p+PPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITI' OF EVERETT PERMIT SERVICES 5 � a - �3 <br /> 3200 Cedar St., Everett, WA 95201 425-257-8810 FAX 425-25"r-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> STEAODRESS: PROPERTVTA%tl PER 1T4 <br /> ` r -� � ' � 5-)foel. /1� �3J�3 'O�JFS � <br /> LEGAL lor new consWclion: Short Plalisubdivision Lot No._ (a�tach npy cf long legal description) <br /> OWNER �j�. �`J > U -��� ). Phone/E�mail <br /> Atltlress (/') - � o � E• O <br /> Ciry/StatelZip =V� � �' <br /> APPLICANT:_Owner OwnefsAgenl Conl�actor Con�rac�or'sAgen� Tenant(n�,eip����aeu�ee�n�c�sr��nomne�wocriaeo»o�x��u��:r�=��� <br /> �ONTRACTOR C 'C' � l&I Lic.# COE Bus.Lic.# <br /> Address.,�,��r� V ��l J' r�• �� U�II��'✓ Phone/Em�il���-�(1-. 3L 7 <br /> TENANT BUSINESS NAME C:.�TACT FOR PERKIT r����,��UCC-0G��"COi'^Ict'�1�!4't i- <br /> �c�er�1 GGh�ti(' <br /> ` c <br /> ����•�'SS ('y�l(cv.;Yl'�' PhonelE-mail.�C.'�/`:�C'-���J <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK yC�M � <br /> Exislina Use of Building r 'a"�"(•'.+\ � HEAT SOURCE: <br /> Proposed Use of 6uildicg����= � -�� r _ Gas _ Eiectrie__ Other_ <br /> Building type: _Single Family _Duplez_Townhouse _Multi-ramily ,�,Commercial <br /> Type of projec�: _New Addition _Remadel _Repair_T.I.__Sign_Sprinkler_Demolition_Change of Use <br /> D(E)SCRIPTIONOFWORK�addttional�spacep�o��dedonthebacti): �h < <� � L;�k:( CLI. <br /> I\C�`�Fdt (r'_lc�����ib� �•pCll 5.��-k'ri ii�,�h'.:11'�� �.� r � v <br /> . r�J • ` <br /> �G�./, 1Wt�rT�� V ^ � � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIY APPLICATION <br /> Typeo(ProJect: ,_New_Addn _A�teratlon_Repalr Typeo(Project: _New_Addn _Alterallon_Repair <br /> S6ow Number(p)o/lixtures Show Num6er(aJ o/7iztures <br /> A/C-airhandlingunits yalhtub � I <br /> Forced air syslems <br /> Gas piping Lavalory(wash basin) <br /> Waler heater I Shower _ <br /> Gas fireplace Kitchen sink&disposal _ <br /> Gas range Dishwasher _ <br /> � Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhausl fan SinF. (service/bar/mopletc.) <br /> Heat pump BacVcflow preventer <br /> Unit heater Urinal <br /> Boiler �rinking Fountain <br /> Refrigeration Floor drain <br /> Woodslove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Olher: <br /> Number of Heads Other. <br /> I hereCy ceNy t�at I ham read nnd eaamineE Ihis appliwtion an�knmv No same lo bo Inio enC mrtect.All provisbns ol Uvn onA oN'�onces 9oveming lhb lype olwoM vnB Ce compGetl <br /> e�dh vRiel�cr specfee herein or nol.Tno Qranting ol e pertnil doca nol presuma l0 9^'v oull�onry lo vioWle or cancel I�o provisbn ol nny ol�er slalo or local law�epuWfng consimction <br /> Thal l am aWhodz�by Ihe ownerol l�is pmpeM�o pe�ortn I�o work forwMch opplketbn b matle antl 1 compy w4h Uo Stele Contractors Lew 1827 RCW ontl 298200A WAC. <br /> ,;� /�� 3_�,- ; �� , <br /> O nerlAuthodzetl Agent Signature Dale (Revised 6/201Y) �y <br /> .; „t... ; � . . .� <br /> �� �" Y_'�. . . � .».n_—_— <br />