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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-?.57-8810 FAX 425-257-8857 www.everettwa.org <br /> 5��- I <br /> SITE ADDRESS: PAOPERiY TA%U PERMIT M <br /> k1� -On� <br /> LEGAL for new conslruclipn' ShoA PlaVsubdivision Lol No._ (atlach copy ol long legal dceniplion) <br /> OWNER Phone/E�mail <br /> ndCress Cdyl51alc2ip <br /> APPUCANT: Owncr OwncrsAgenl �Conlraclar Conlroctor'sAgeN TCOB���RuflponJuakerrolconsnnhwnNeawoqb�owalini�os0ecq <br /> CONTRACTOR � O Slale Lic. # QC 6 Cil Bus Lic.# <br /> Addiess�!�- p Phone/Email l ZS q1 - 4 fo 1 <br /> TENANT BUSINESS E CONTACT FOR PERMIT <br /> Phonel[�ma!' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � <br /> Existing Use of BuOding_�� HEAT SOURCE: <br /> Proposed Use ot Buildinn Gas _ Elec�nc__ Other_ <br /> Bwlding type: �Single Famtly _Duplea_Townhouse _Mul�i•Family !.Commercial <br /> Type ot pro ecl�. New Adddion Remodel � Repair_T I __.Sign Spnnhler___�emoll�ion_Change ol Use <br /> DESCRIPTION OF WORK(ado�r�onai space providee on ma oac.� <br /> " /�QQ �?OOF <br /> MECHANICAL PERMIT APPLICATION PLUMSING PERMIT APPLICATION <br /> TypaofProJocl: _Now_Addn _Alleratlon_Repalr TypeolPro�ocl: _Now_Addn _Altorotlon_Ropalr <br /> Show Num6er(�J olllxfuroa Show Numbrr(M)o//l+turef <br /> NC—air handling units � Todet <br /> Forced air s s(ems Dalhtub <br /> Gas i ing I.avatary(wash bosin) <br /> Water heater Shower <br /> Gas fireplace Kilchen sink d disposal <br /> Gas range Uishwasher <br /> Clothes d er � Clothes washer <br /> � Ran o hood Water heater <br /> Exhausl lan Smk servicelbadme letc <br /> Hcal um Backflow preventer <br /> Unit healer � Urinal <br /> � BoUcr bnnking Fountain <br /> � Re(ri cration Floor drein <br /> Woodstove � Greasa IraP � <br /> Duttin �� Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRE3810N SYSTEM O�her: <br /> Number ol Heads � O�her. <br /> I�ereby cemly i�at I heva�eatl and e�aminetl Ihb appAcalwn and knuw IAe aame to ba Ima ond wimcl Ad pmnswns ol lawa ond OiCinancef gavemin9l�ie lypo ol woik xMl Do camp�MA <br /> vntll wllothef spartlietl tlNein a1 nol.The gianling d e permtl does nol pmsume la grve aulhurily lo vial.lto ol W ncel Iho D�onsion ol an�oNer Nufe or bwl ITM legu�aling<tMslmclbn <br /> iTol l am auihonx0 Oy I�a owncr o11Ais prapehy to ptqoim I�e wak loi v.Tuh npPliwlian le inaAe end 1 mmply wAh Ihe Sla:e Canliectme law IB77 RC:'/und 296 t00A WAC <br /> �h1 o6�l�i_ <br /> Ow alAuthorlxad Agont Siqnaturs Date (RevisodYl0i3) <br />