|
v� F�
<br /> {
<br /> { '
<br /> P' y �
<br /> i
<br /> :,:;g�.�.,,:t�,
<br /> k"
<br /> � .�„ �
<br /> ;,,H.,..,
<br /> PE�RMIT APPLiCATlO�I ' "�
<br /> :.� .�
<br /> � � �- �
<br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLiTION �`�r�R�
<br /> � �, �.
<br /> CITY OF EVERETT PERMIT SEP.VICES ��^��
<br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everethva.o�rjg ;�
<br /> APPLICATIONS ARE ACCEPTED FROM B AM TU 4 PM o�I`�o? p ��Z �i �'�tt' .,
<br /> SITF� .PJ��• �^'� PROPERNTAXq P MIT I ( ::
<br /> O�•`IO� Z 5�• � £�� f� �,� �� -1 , .,� ��.
<br /> LEGAL for nem consiruclion: Shotl PlaVsubdivision Lot No._ (aUach copy cl long legal desc�ip�ion) � ""'
<br /> $
<br /> OWNER ( ��s/F-��G! �LrS^`Hf/�` PhonelE�mail ���
<br /> �..�rw��� .
<br /> Address S Lu'�I' CirylStat^.2ip G(fzJ�£( / .. .. ...>�._���
<br /> .r<,^
<br /> APPLICANT: Owner OwnersAgent Conlrac�or Ccmracw:'sAgerd 7enamc�.�vc�=.�aoarr.�roi�_necmnommoo��weowod�.,:^..:p�:e) `''-
<br /> CONTRACTOR �LJ��tIL O. Cl�w''FGCD � L&I Lic.# ���aC(O� I�LT COE Bus.Lic.# ��""' y
<br /> AdAress �Cfe1.] �OWLf� �2 Ct�, 11j Phone/Email L�j,. 3T�' O�Z�-- � 7' ,�'Y�`
<br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT ' �j,�
<br /> U,� l"�UYLLI� /� �" C� ,�
<br /> a�+a.s- p�q �L�e ���N� �,�,�w�-� � II ��.
<br /> 3 / ^ S / . �,{f/[ R-C 1'�l.s`L Phone/E�mail 2 S � 3 — Fli Z I •'�k�a�
<br /> 6UILDI NG PERMIT APPLICATION CONTRAC7 PRICE OF woRK '�' � " ' � ,� ."..���;
<br /> Existing Use of Building HEAT SOURCE: ay,��`
<br /> Proposed Use of Building Gas_ Eiectric_ other_ ���" _
<br /> F
<br /> Buildino rype: _Single Family _ _Duplez_Tcwnhouse _Multi-Famity _Commercial t`� �t'�'�s
<br /> Type of pro�ecl: New Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Chanye of Use ��ry� `
<br /> — — r^Y�:^
<br /> DESCRIPTION OF WORK(atlditional space provideC on the baeN/: v -,
<br /> ��.,-�v-;�,w �o �x�s;,N� �f/=/GF �,���� — z ti�w ,�-a �t �
<br /> ��:
<br /> ��£. ,
<br /> Co,M,����-ni T 8�t7n`kcr�m5 _ : ;�'�,�
<br /> �.
<br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION ��,��
<br /> TypeofProJecL _New_Addn _Alteratlon_Repalr TypeofProJect: _New_Addn _Allera0on_Repair i�-.��<.1t.,
<br /> Show Number(N/ollixfures Show Num6er(N)o/lixfures
<br /> Toilel ���-'
<br /> AIC—air handling units �.;�w'. ,1j
<br /> Forced air systems Bathtuh n f"a
<br /> Gas pipin Lavatory(wash basin) ��` ;#�����j
<br /> 9 .;
<br /> Waterhealer ' � Shmver � -'���i+"�y++3�
<br /> Gas fireplace Kitchen sink&disposal �� ,r_;�,;�.�
<br /> � � Gas ran9e Dishwashec �-�+ --�-� -b+*'
<br /> Clothes dryer Clothes w�>her ,..'`�.fP'"�
<br /> Range hood I Waler heater 1 '��'�y�� ;q.' _h
<br /> Exhaust fan I Sink(service/bar/mopletcJ , �'�yy��y�
<br /> Heat pump � Backflow prevenler �,_� ;
<br /> Unit healer Urinal ' ""`n^' "�
<br /> Boller Drinking Fountain * �
<br /> Fioor drain ,r'Y`. ,
<br /> Refrigeretion -`.','�._^; �:,
<br /> Woodslove Grease Irap y�9�< �
<br /> Ductin Roof drains :;�,7�"'y
<br /> 9
<br /> � Other Aledical Gas � . � ��'
<br /> SPRINKLER / SUPPRESSION SYSTEM � Other
<br /> ,��
<br /> Nurcber of Heads Other: ' a
<br /> { ��
<br /> I hereby wNty Nol I hevo reatl antl examineA Ihia apP�icalicn nntl know Iha same lo bo Imo and ronect.All pmvisiona ol laws ond ordlnances goveming Ihis rypo of vrork vn�Ca cumpfied ( Rr�r�f.{J'j�
<br /> wnh�Met�et specified� ' o�mL Tho granlinp ol a permil tloes nol D�esume lo give euthonry 10 viola�a o�cancel Ne P���ision ol eny oNe�sinte er lowl l'x repulaling cons�mction - : �r.'.
<br /> Th ul�oiizeC /theoweraflhispmpeM�o etlortnNovmrklotw�ichaVPlicationiematlonndlromplywd�l�oSinloConVaclonLnw1827RCWend298200AWAC. �
<br /> I �
<br /> !2 -z� -rL-- l z � ,�f��� `�
<br /> h
<br /> Owtler/Aulhbrized Agent Signaturo Date (Fevised 6i20i21 '
<br /> r � .��;
<br /> t�'' ... '`_•k:
<br /> _ . ..�'..1�
<br />. . l(..F.
<br />
|