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PERMIT l�PPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED fROM 8 AM TO 4 PM � �a- �� <br /> SITEADDRESS:��� / �(04��� <br /> PXOPER7Y TAX p PE MIT N —� , <br /> LEGAL lor new construction: ShoM1 PlaUsubdivision Lot No._ (altach wpy ol long legal tlescription) <br /> OWNER vC.)CU��� �✓SG Phone�E�mail y � L�� � � <br /> Address a y ��/JG /r!-r� City/S�ale2ip <br /> APPLICANT:_Owner OvmefsAgent �Contractor Contractor'sAgent _Tenanlf�u.�cm�a••knermm�uemnommac.*�eioao�n�nm•ip+m) <br /> CONTRACTOR K�u M r/-'�4.+i��l� -�rAG �81 uc.u �DA1�r. 1''�od�c'J' coe eus.uc.n <br /> Address 3 3S3v /s Gv .�l� �/Q� Phone/Email �(53-`)�'fS' ��` <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT SAMCS �G4 N��'� <br /> G(��C70/� //QC�✓� P�onGE�mail [�15� S�� �3�/ <br /> BUILDING PERMIT APPLICATION CONTrtAcrPRICEOFwoRK a c <br /> Exisling Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Eiearic Omer <br /> Buildingtype: _SingleFamily _Duplez_Townhouse _Multi•Family _Cammercial <br /> Type of pro'ect: New Addition Remodel Repair I'.1. Si n Sprinkler Cemolition Chan a of Use <br /> DESCRIPTION OF WORK(aeai�rona�space prov�aea on me bacq: / <br /> ��.,r 3 N�...� f�Hf.rS7� Fi�f�, A�JJ S/A �u IA�^L�r (�JJM <br /> v�.r l- N...� A�y.� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProJecl: _New_Addn _Alleralien_Repalr TypaolProJect: _New_Adtln _Alteralion_Repalr <br /> Show Num6cr(M)o!lixmres Show Numbe�(i�)ol fiirfures <br /> AIC—air handling units Toilet <br /> Forced air s stems � Bathtub <br /> Gas pipin Lavato (wash basin) <br /> Waler heater Shower <br /> Gas fire lace Kitchen sink&disposal <br /> Gas ran e Dishwasher <br /> Clolhes dryer Clathes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(servicelbadmop/elc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Re(rigeration Ploor tlrain <br /> Woodstove Grease lrap <br /> Ductin Roof drains , <br /> � Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> Number of Heads Olher: <br /> IherebycertAylhall�a re CanEeKamneJ�l�isapFlcationonOknowl�aeamcloOeWeendm�cl.h9pmv¢ionsollawinndortlnancmgavemhONblypealworkxilbecompfeE <br /> rn�h�MeUMs euEe e nmwLThoprentinpofopertnildxanalprtsumoloB�'oouNorityloNo�ateortnncellt+oProNsbnalenyoNersWleorlacallawrepulalb0�onswcUon <br /> Tlmllnm odxc byl ownero/IhlapropmlyloPc�wmNewo�Icio�whkhe0DkalqniemadeantllcanDHH'��No51n1eCanUeclonLewiB27RCWend38B.200AWAC. <br /> � � <br /> ner/ ulh zetl Agenl Signature Oato (Aevised 6/20141 <br /> ( <br />