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PERMIT �PPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> ��7�i <br /> SITE ADDRESS:� ?,D r P�a.Jcer PIIOPERIY TAXA PE � � � ^ <br /> J `/ �, <br /> LEGALlor new construclion� Shorl PlaUsubaivlsion Lot No._ (atlach copy ol long legal descnplion) <br /> OWNER �6 h n �hCC e r- 4.r�bor n ^Phd�Mna yy/.Z (1 � (Yl f0 t �er�COYY1 <br /> Address � PI, IV CitylState/Zip � w/ 1 / �� � <br /> APPLICANT:___Owner OwnefsAgent ConVnclor ContraclofsAgenl _ienantlR.�n��orae�iensraw�erno-omm.w,xrmeo«on���o.�a.=�I <br /> CONTRACTOR l�h �• S� � p State Lic.# L N 14s81K c�� a�g. ���.« o476Yy <br /> Address y' � Ot����• ��L«� �` o'Z� ( PhonelEmeil ��� 11D Z��� �' <br /> TENANTBUSINESS NAME CONTACT FOR PERMIT K DO��� ��� y� <br /> O <br /> PhoneiE�mail �� �7���S *���' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK v��J'S' l D00 _ <br /> Existing Use of Building .5 _ NEAT SOURCE: <br /> Proposed Use of Building__ __ Gas Eleclric Other <br /> Building type: X Single Family _Duplez_Townhouse __Muiti-Family ._Commercial <br /> T pe of pro'ecC New Addition Remodel Repair ✓ T.I. Sion Sprinkle_�_Demolition_Chan e of Use <br /> DESCRIPTIONOFWORKlnddnionaispeceprovidedonmonack): .Lns{,a�I Me•�.v( -fy,bW,�4• h4,y1l�('4i� <br /> q� Poral.. +p SI�e wa,I Ic.� �ow rt s.econd -F l� �h�t o{= � �Fe.:r� . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoolPro�ocl: _Now_Addn _Alloretlon_ Repalr TypoolProJec!: _Now_Addn _Alteration_Repalr <br /> Show Numbcr(M)o//lxfures Show Number(M�o/Il.furoe <br /> /4'C -air handlin units Toilet <br /> forced air systems Ba�htub <br /> � Gas i in � Lavato wash basin) <br /> Water heater Shower <br /> Gas fire lace I Kitchen sink&disposal <br /> Gas range � Dishwasher <br /> Clothes dryer Clothes washer <br /> �— Range hood Water heater <br /> [nhaust fan � Sink(servicelbar/mo /etc) <br /> Heal um I Backflow reventer <br /> Und heater i Urinal <br /> �oiler �rinkin Fountain <br /> �— Relrigeration I Floor drain <br /> Woods�ove Grease tra <br /> Uuctin Rool drains <br /> Other__ Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> � Number of Heads � Olher: <br /> ;hereLy cua�Y�bul I I+a+e ie�l and on�mmeE Ihs apy!�cn'.en end Fnuw Ihe saTe lo�a Ima enA mrrect AA provisiona ol lexa end ora�nan<e�poveminp l�if tyDe olxvrk will be c+mplied <br /> x:ih wneRier speo�rcd Pe�e��n cr noi The q�ammg ol a perm t aoes nol presume lo prve aatnoMy to vrolale a aMel I�e provi�ion ol eny other tl�ta a bul Irn reyulelinp conrtructan <br /> 1 nat I am u��nrnieE ey ine oxner cl lna pmpetly ta pedurm Ine wurk/or���ich npF��wlan b mede end I rompry wtl�t�e Sieb Contnclrnf l�w 1817 RCW�M Y9b 200A WAC. 1 � <br /> �/�.��'��� �l�-3 � <br /> OwnorlAuthoiizad �niSignaturo Date (Reiised3201J) <br />