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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMf31NG/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425•257-6857 www,everettwa.org <br /> SITE AUDRESS: PnOv[nTv inx a PERMIT� <br /> Gl G�C. � � -� � � <br /> LEGAL tor new conswc�ion- S�ch ViaUsuoArv�sion Lot No_ (anacn copy ol long lapai descnptlon) <br /> OWNER PhonUE�mail �a 7Ll N '7 S� s <br /> Add�ess City/blale2ip <br /> APPLICANT: Owner OwnefsAgent Canlraclor CanVaclorenganl Tonanl�Tu+�D�o.+a.u.ne�o�ronvm�vmmeo.�.rioeo.vnna+�o•UI <br /> CONTRACTOR M vc,� PI u., ��'� State Lic p MOc/`P�'� .�J'U c�� e�s.uc. a OS S�n 3 S <br /> AnO�ess I�515 yi �5l- SG Si�o �n� � W � �/ ZyU honelEm Ij fr16U Nw�� r^ to� <br /> TENANT B I ES NAME CONTACT FOR PERMIT <br /> P�onelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> EKisting Use o(Building_ _ HEAT SOURCE <br /> Pmpo fd Usc of Building Gee_ Elec�nc_ O�hor <br /> Bwlding lype. ___Single Family _ Duplea_Townhouse _Mdlli•Femily _Commercial <br /> T pe of pro ecl New Addihon Remodel Repeir_T I _Slgn rSpnnkler_Demolilion_Change al Use <br /> DESCRIPTION OF WORK(eddd�nnni snece p�ovidea on me Dack1 <br /> .lnr�Lli 3" ��� �3v v�l„� a- �,Z� �«k.-.._�-�+ u-l.� ,'... R<K,�c.�r <br /> MECMANICAL PERMIT ARPLICATION PLUMBING PERMIT APPLICATION <br /> , YPQ ai Frojotl: _New_Atltln _Allentlen_Repelr iypo of ProJael: _Now_AdAn _Allenllon_Repalr <br /> S�ow NumDer(M)o//lrfuros Show NumDer(NJ o/flrtuies <br /> NC—air handimg umts i Tailcl <br /> ForceA au s stems Bathtub <br /> Gas pipmg Lavatary(wash besm <br /> Walen c�aler Shower <br /> Gas hreplace Kdchen sink L disposol <br /> Gas renge Orehwas�er <br /> Clolhea A er Clolhes washer <br /> Ran e hwd Watcr heater <br /> Eeh0u5�lan S�nk(servicelbar�mop/alc) <br /> Heel pump Backliow preventei <br /> Und healer Unnal <br /> Baler Drinkmg Fountam <br /> Refri eralion Floor Orein <br /> Woodstove Greaso Ira <br /> Ductin Ruol drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM o�her. <br /> Number of Heads Other <br /> I�em�y QnM Ih�1 I�evo maE ontl cramineU IRs eppilrahan end h�ww I�e�ame to Oe�nn�nA mrtecl IUI Oi�^srons al lawa nnA oNinenRs qoveminp IAis rype ol woA will Ee mmpaeE <br /> wM wiwtMr�D�'ed�emin or nat Tne gnminy al�pmm�aa�nol D�asums lo pm nnnortry lo vroma m unml ma pmwpn ol any otner e�ne or iwuew rcpwa��nq mnswaan <br /> Tn�l I am aul�omeU Oy Me o+mer of�nb Dmqrty�o prform��a work�a�witicn ooV����on h maE��nE I campry wn�11ie Sltle Con�qqas l�w t A 77 Rf.W mE 79C 100�W�C ,I <br /> � /� �?—.�c__ � ^ I�/- /S I <br /> Owner/Au(horized Agent Slgnalure Dale (Revised Y1013) <br />