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PERMIT AFPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, E�erelt, WA 98201 - 425-257-8810– FAX 425-257-8857 –www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE AODRESS: , � , VaOVEnTV Ta%tl PE MIT t <br /> , !1� � r: '� , t e <br /> IEGAL lo�new constmdion Short PlnUsi��drvision _ ___ ___�-ot No ___ lallach copy ol long legal desc�iplion) <br /> OWNER PhonNf�ma�l <br /> Address CitylSta�e/Zip � <br /> r . � " i7 /:�. . , �.. � <br /> CONTRACTOR �'�� ` ' � % � ' L 8 I Lic. �I � �` � <br /> AtlAress . , .• �/' .� -1�: /. � i �.�-' PhonerEmail �� � 1 ' � � , <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> ������� � PhonML-mail <br /> BUILDING PERMIT APPLICATION cONTRncT rRice oF WoaK �. � ' � — <br /> Ezisting Use ol�uilding ___ _---— HEAT SOURCE�. <br /> Proposed Use of Building_____ __ _ Gas Elr.ctric_ Otner_ <br /> Building type: Smgle Family _Uuplex_Townhouse_ Mulli-Family __Commercial <br /> Type of projecl _New _Addition _Remodel _1 Repair�TJ. _Sign._Sprinkler__Demoldion_Change of Use <br /> �e5tripiion ol Work(addrtionni space p�ovined on I��e bnckl�. , . '� - ;a'- r"' " . � / � � � � �, <br /> i ..�.� <br /> Have you started working without a permit7 __ YES __NO <br /> MECHANICAL PERMIT APPLICATION PLUMBINb PERMIT APPLICATION <br /> Type of ProJact: _New_Adtln _Altoratlon__Ropalr Typo ol ProJecl: _New_Addn _Alterallon_Ropalr <br /> Show Numbrr(M)of lixturei Show Numbcr(N)o//ixfurce <br /> I <br /> FVC–au liand��n �.•mts I Toile� <br /> Forced a�r systems I Bathtub <br /> Gas pipm I Lavdtor (wash basin) <br /> Walar heater Shower <br /> Gas t,replace Kdchen sink 8 dis osal <br /> Gas ranga D�shwasher <br /> Ciothes dr er Clothes washer <br /> � Ran e hwd VJater heater _ <br /> � Exraust fan Smk�se�vicelbar/mop/etc� <br /> � Heat pump Hackllo�v preventer <br /> � Unit heater Urinal <br /> Boiler Drinkin Pountain <br /> I Reingerahon Floor drain <br /> ' WooAstove Grease trap <br /> � Uuc6ng Roof drains <br /> Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other <br /> ! Number ol liead5 O�heC <br /> 1 I�ereUy ceitdy R��al l have irad end ewamined Ilus apptication and know Ihe same lo be Irue and cormct All provigions ol lews end ordinences goveming <br /> ihis lype ol work will be comp6ed wtlh whMhei specified herein or nol The yranting oi a permil does not presume�o give authority to violale oi cancel <br /> Rio�p'eyision ol ony oltwr state or Iocal Inw regulating constmcllon or Ihe pe�fom�ance i .onshuction Thal I em auihonzetl hy Ihe ow�irr ol Ilus pruperty <br /> lu perfolm the vio�k lor wMdi npVlicatr�'Is niade nntl I comply with Ihe Slale Contrectors Lew 1B 27 RCW end 298 200 W�C <br /> i �� S ��� ����.�f���( �� <br /> O dAulhorixad Agont Signeluro Uatn �Rev�se�Pi707 t1 <br />