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� � <br /> PERIVIIT A,�PLiCATION <br /> BUILDIN�/MECHA4�ICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wuvw.everettwa.org <br /> SITE ADDRESS: � PROPENTY 7A7(q y P ���T� _ OD <br /> �� N� <br /> � LEGAL(or new conslruclion: ShoA PlaVsu6divlslon Lot No._ (eflach copy ol lon�legal descdpllon) <br /> i <br /> OWNER �sck� e- 1-'��z � o P�onelE-mail � O(o 3� (�7a 6 <br /> Adtlress . ciry�slalc2ip <br /> APPLICANT: Owner OwnnYSAgent CoNr,.qor Canlractoi'sAgent _Tenant�musiv��onicn�ao�m�:a�irRmu,oavncrmaowaMiomocpam� <br /> CONTRACTOR /v7 UG,� ���-r�-� �'r��n � Slatc Lic.N MDC/�PP�Sl�>'J U .aiv e�s.���.x OS 3�s S <br /> ned�ess 1751 S ylS'`$}- 5� Srw on�' �. W I�+ �i sS'Z4U t�one Emai �3�� I <br /> S 1/'Cn�� hlu��I�l�-r,n i n , c 4�'^ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> P�onclE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORf( <br /> Ezisting Use of Building_ HFJ�T SOURCE: <br /> Praposed Use of Builtling Gas__ Eicaric___ Otner___. <br /> Building type: _Single Family _Duplez_Townhouse _Multi-Family _Commcrcial <br /> Type ol project: New Atldition Remodel Re air T.L__ Sign_S mikler Demolition__Change of Use <br /> DESCRIPTION OF WORK(add�ional spuceprovmnaon mc oack): <br /> y„fd-� � � ����: �.,�� �,t,,.� �r �.����- <br /> MECHANICAL PERMI7 APPLICATION PLUMBING PERMIT APPLICATION <br /> Type a/proJoct: _Now_Atltln _Altoration_Rapnlr Typo of Projacl: _New_Addn _Alloratlon_Ropeir <br /> Show NumDer(d�ol flxWres Show Numbcr(q)of(irfures <br /> A!C-air handling units Toilel <br /> Forced air systems Balhlub <br /> Gas iping Lavatory(wash basin <br /> Water healet Shower <br /> Gas fireplace Kitchen�inR 8 disposal <br /> Ga;range Dishwashcr <br /> Clolhes dryor Clalhes wnsher _ <br /> Ran9e hootl Water hoaler <br /> Exhausl lan Sink(servico/bar/mop/elc) <br /> Hcal ump � �ack0ow preventer <br /> Unit hoatcr Urinal <br /> Boiler O:inkinq Fountein <br /> Retrigeralion Floor drain <br /> Woods;ove Grease Ira <br /> � Ductmg Roof drains <br /> Othcr MediCdl Gas <br /> SP�2INKLER / SUPPRESSION SYSTEM othec <br /> Numbcr of Heado O�hcr. <br /> I pam�y c.rrlAy Ihnl I hnve mad nn�crnmined Ihiv npp!icnlian nn�know Iho mmu lo be Imo nntl cormc�.All ymvi5lom o}Imr.nnC otEmnnrn�goveminQ Iplg IyDo o!wod w I�e comDPM <br /> w;^M�mper�pcnpce ncmin ar nol.Thn 9mnllnp ol a pumfl Ocea nct pmsumC Ioqivc nul�atliy lo vIOI�4C of WncCI lOC pIWL'lOn of Gny ol�ef',iBiC of l0411 Ipw fCpuldling t4n51rtidlon <br /> Thnf I om nuthori[c0 Gy Rm mmcr of Ihis pmperry lo pertoim��o worx tor wni�appllwncn I;maee nnC I comply wfJ11�e Slala Conlmnoa Law ltl d7 RCW ontl 296 700A WAC. <br /> �' ��- �-.� - ,� <br /> OwnnrlAulhodred Apnnl Signalu�v pole (Rnw;rd?907?) <br />