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� , <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALlPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-6810 FAX 425-257-8857 www.everetiwa.org <br /> � z-a <br /> SII E ADDRESS: ^ n� PROPEnTY 7AX u P.E IT it <br /> L r1 <br /> LEGAL for new construction�. Short PlaVsubdivision Lot No._ (anach copy ol long legal tlescnD�ion) <br /> OWNER ML..IV �j-�uc..� PnonPJE-mail �� � ��4 y0 �41 <br /> Address I� �� (JyLr,L �t � CitylS�ale/Zip <br /> APPLICANT: Owner OwnerSAgen1 Cn-1fa[�or ConlraclofSAgen1 TenJnl�mm�poYaooiona�mconsomtnninawrorroao.cninv+aspau� <br /> CONTRACTOR M ve,� PI U� h�'� State Lic.M MOen P�,�-�l 3T U car o�s. uo. a OS 3�3 S <br /> AaAiess 175� 5 y1�5} SC rj�w �r.,� l, w N 98z�v P�onelEma fr36u �� � M��L^��w ta� <br /> TENANT BUS�NESS NAME CONTACT FOR PERMIT <br /> P�one/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use ot 8uilding HEAT SOURCE� <br /> Proposed Use of Building - Gas_ E�ectric_ Othor_ <br /> BuilCing typr.: _Single Family _Duplex_Townhouse _Multi-Famlly _Commercial <br /> Type of pro ecl New Addition Remodel Repair T.I. Si n_Spnnkier_Demolition_Change of Uso <br /> DESCRIPTION OF WORK(add�Gona�spacop���aeeon me eack) <br /> i/`)�Z �� l �/2 �' �- ISU� <br /> MECMANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typc of Project: _Now_AdCn _Alteretion_Repalr Type of ProJotl: _New_Addn _Altoralion_Repair <br /> Show Numbcr(N)ol firtures Show Numbci(N)o/flxturss <br /> A/C—air handling umts � Toilet <br /> � Forcetl air s stems Bathlub <br /> � Gas piping Lavatory{wash basin) <br /> � Waler heater Shower <br /> � Gas fireplace I Kdchen sink 8 disposal <br /> Gas range Dishwasher <br /> � Clothes Aryer Clothes washer <br /> Ran e hood Walci heater <br /> Gxhaust fan Sink(servicelbar/mop/elc.) <br /> Heal pump Backflow prevenler <br /> Unit healer Unnal <br /> Boiler Dnnkmg Foun�ain <br /> Refrigerauon Floor drain <br /> Woodstove Grease lra <br /> Uuctmg Rool drains <br /> Other Medicai Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Olher: <br /> Number ol Neads � Other <br /> I�em�y ceMy I�al I�mo�ceC on0 c.aminr0l�rs nppllLi7an nnE Fnow IAo samo lo Eo Iruc nn0 mnecl.All O�avislans ol law9 onE ordleenwi goveminp IAis typn n�wo0.'M�I Ee mmplic0 <br /> wM wTether spttlied OeRin or nol 7Te gmNing ol a petm�Eocs not prosume lo gNa out�oflly lo viotete or qnCal VIa D�'/�slan ol any oNer Stalo ar loral lew regulaling Canstlunlon <br /> ThaU am aN�onxoE Oy NC ovmet ol Uis ploparly lo poRorm No wolk fot whlN uDD�iWUon b mJOe Bn01 fAmpiy Wtltl NO Siale CanlrJtlors Law 1B I7 RCW anE 196 300P WAC <br /> 0��7 �-�- i z-z5 -�� . <br /> Owner/Autho�izod Agent Slgnature Datc (Revised 3?01JJ <br />