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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CeJar St., [verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADORESS: aaopEnn rnx p Mir <br /> I�I � �akf f} �e ��-cr-�'t Z - 0�3 <br /> LEGAL lor new construction�. Shon PlaUsubtlivision Lot No._ (allach copy ol long Iegal descnplion) <br /> OWNER �/le i� � PhonclE�mail '�{a 'f 7C� (o�� <br /> � f � <br /> Address � Du�S City/SIatMZip _ <br /> APPLICANT: Owner _Owner'sAgent Conlracior __Conlractor'sAgent TCnanl�mus�pmwoaioneiolw�..+ tec.nmoc..neriaaowodin¢aspa<el <br /> CONTRACTOR Yi OGI� ��a.h % State Lic t! 0 i �-��Y Bus. Lic # 1753 3S <br /> nddress ��S/ f1'S/' � � . l wfl Cc� Phonc/Emai� �.('y� 7 (� U 6 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PnonclE�mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Dwlding hIE�T SOURC[�. <br /> Proposed Use oI Duiltling Gas__ Eledric_ O�her._ <br /> 3wldmg type� �Single Fanuly _Duplea_Tov+nhouse __Multi-Fam�ly _Commercial <br /> Type of pw�cU�. New Addition _Remodel _Repau_.T.I _Sign_Spnnkler_Demolition__Change of Use <br /> DESC RIPTION OF WORK�atld�honal spacc pwv�drei on thc D.¢k) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: _Nr.w_Addn _Alteration_Repair Type ol ProjecC _New_Addn _Alteration_Ropair <br /> Show Nuntber(qJ o/lirfures Slrow Numbcr(H)ollixfures <br /> � A/C—.ir handliny unds � Toilel <br /> Porcrd air systems � �athtub <br /> � Gas pipmg Lavalory pvash basm) <br /> Waier heatef Shower <br /> Gas fiieplace � Kilchen sink 8 disposal <br /> � Gas range Dishwasher <br /> � Clolhes drycr � Clothes washer <br /> Rangc hood Water hea:cr <br /> Fxhaust lan � Sink (servicelbadmoplelc) <br /> Heat pump �C I DackOow preventcr <br /> Unit hcater Urinal <br /> Bo�ler Drinking Founlain <br /> Refrigeration I-1oor drain <br /> Woodstove Grcasc Irap <br /> Ducting � Roof drains <br /> Other Metlical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM � Other: <br /> Number of Heads I Other <br /> I heic�y cenily Ihal t hnve reaC anA e�aminetl IOis appbcaLon,n0 hnwi IPe s�me to Ue Ime and wrrcd Aii proiisian;al lae;and or��nan<e,qovem�ng Inu rype ol woik wa be<ampbe0 <br /> wtlq whrltter spr�,ired�ercin or not l0e 9rdNmg ot a permit EocS nol pmtumo lo tJrve aul�op!y lo wo�alc nr ranrol the prrnumn cl any N�ef C:de or iocdl Idvv�equlaLnq convlrocl.on <br /> Inat I ain aul�orvetl Gy nro ux+iei ol l�u pmpeny lo pertorm Ine vm�k foi��h�c��aPPiKation ii maUe an�I ms��ry w'ni Inr,�,I,ilr Conlo�c�o�:Lre Ifl 77 RCVI amf)7fi 700A WAC <br /> �,�- � ?�- 12� �r-I 2 <br /> OwimrlAulhoraoef ngent Siyn.luw �ale fRevised 7R0171 <br />