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PEI�MIT ARPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt,WA 98201 425-?57-8810 FAX 425-257-8857 www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I� � �j —/ <br /> SIT ADDRESS: PROOPER7xTC%�2 �O "� P MITp <br /> 21 B oo.�-i,✓ �"� <br /> LEGALIor new wnstruction: Short PlaVsubdivision Lo�No.__ (attach copy of long legal descnption) <br /> OWNER �OCOt� RO PhonelGmail L � - Z��'— `�80 Z <br /> Address Z Zq �l�Qr J7" City/Slate/Zip �Jp/eU WA �O� I <br /> APPLICANT: Owner OwnefsAgeni kCoNreclor �COnitat�0Y5Ag2n1 _TCwul(*mtpmvtieekt¢r�nconsemkommaa«nawCov.vninnospoa) <br /> CONTRACTOR , fG � U�M t�t(� L 8 I Lic.#r�MZL3RE r D SPNCOE Bus.Lic.#O O 9 O <br /> /�I �q qOp�L PhonelEmail 3�0 � �e� - 3�0 <br /> Address �� (�hiG� C4Man0 3. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �JCOO� �IOI/.-S 'e rhonelE�mail �Z�^ ��� ^ 'J �O� <br /> BUIIDING PERMIT APPLICATION CON7RACTPRICEOFwoRK I( Oc7 <br /> F�cisling Use of Building HEAT SOURCE: <br /> Proposed Use of Building Oc��an c� 6 Gas k Eiectric K Omer <br /> Building type: _Single Family _Duplez_Townhouse _Multl-Family �Commerciai <br /> rre� pwMp. <br /> T peol ro'ect: New Addilion Remodel Re air YCT.I. Si n S rink�er Demolition Chan e ofUse <br /> DESCRIPTION OF WORK(adaiiiona�space pro��ded on the baca): <br /> A,��, hpA Ras+�oo�s �' L��.��y 2o�r� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypaolProjecl: _New_AJdii _Alteralion_Repalr TypoofProJect: _New_Addn �Alterellon_ftepalr <br /> Show Numbcr(ll)o!lixfures Show Num6cr(k)olOxturcs <br /> A/C-air hantllinq units Toilet <br /> Forced air s stems Bathtub <br /> Gas pipin Lavalo (wash basin) <br /> Water healer Shawer <br /> Gas lireplace Kitchei sink&disposal <br /> Gas range Dishwasher <br /> Clothes d er I Clothes washer <br /> Range hood Water heater <br /> Ezhausl fan Sink(service/barlmop/elc.) <br /> Heal pump 0ackfimv preventer <br /> Unil heater Urinal <br /> Boiler Drinkin Founiain <br /> Refrigeration 2 Floordrain <br /> Woodstove Grease trap <br /> Ductin Roof drains <br /> � Olher Metlical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby ceNfy tliat I haw rea0 antl examme�tliis apP�Kulion an�knrnv I�a aamo to Oo W o and mrtect.All provisianf cl uws onC ar0inancee povemhB��ie rypa al wak vnl ba comp4ed <br /> wnh vAieNm spatlfktl�emin of noL Tha p�antinp ol a pertnil donf nal pmfume to pNo nuNonry to Nolsle or cancel l�o provisbn ol eny oNer slate or local law repuWfhp conslrudion <br /> Tnat I am euNodmE Cy Iho amer ollhia pmPery lo pedam I�e wak fw whk�appkalbn b mo7o enE I canpN�h No Slnle Convaclan lsv 1B 27 RCW nnE Y80.2 WA WAC. <br /> ��---� r/23/0�3 <br /> Owner/Authotlzod Agont Signaturo ate (Revised 6/10111 <br />