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,':;. L [�:!12 1 : 26"r'"v� tV�ti6�EE'J tiT�TE HtAi � AC ,.. 1�62 � � <br /> rERMIT APPLICATION <br /> BUILDINGIMECHANICAL,/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OP EVERETT PERMIT SERVICES <br /> 3200CedarSt., Gverelt,WA98201 -A25-257-8£i10—FAX�i25-257-8857—�wwv.ovorotlwa.or� _I � <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO b PM . <br /> SITG ADDRESS: r��1 PROPERTYTA%# E���S�(„J..'(�. <br /> aL <br /> L[GAL(ornewconsWctlon: ShatPlaVsubdivisb LolNa._ (allechcopyoltonglopaldesulpllon) <br /> OWNLR 1 b}'1 1 Phone/E�meil �a - a - a�� <br /> Addres9 1� � f�vQh \ � GIy751a1e21p �v p �,1�1 qgao <br /> CONTRACTORGY V� '�I CIA:tOV� L R I Llc.il �'e S l� a'a- ^ <br /> AJdres. �'� C � V —1�O'� ' PhonalEmall �4 - �.5 a- 3 � <br /> T[NANT 9U31NE93 NA�dE oI10 �� ��e CONTACT FOR PERMIT1.,l,��`� Pn , ,,� , <br /> l. �...-.� , T <br /> ' , — PhondE-mall <br /> Blilti. iN(3 PERMIT APPLICATION CONTRACTPRICE OF WORK 8 � � <br /> ExIs1In�Usoot9ulid�ng HEATSOURC : <br /> Proposed Use of pWlding �a^�" Gas_ EleciAc omer_ <br /> ouilding type: _Singie�amlly,_D�plex Townhouso _MuIU-Famliy �CommarGal <br /> TypeoiproJecL• _Naw ,_Addilion _Remodel _Repair_T.I._Slfln_Sprinkler_.,Domoll0on_Chengo ofUso <br /> OesaipUonofWork(adBltbnalspsceproNdedonlhebeck): ���� � �� � <br /> !� . � _ 1 � ' _ <br /> � ° / L� Ke 1�„-� Pw�nw� �, n� <br /> Havo you startod warXinp v+'�thout n permil9 YES „�70 <br /> MECHANICAL PERMIT APPLICATION PWMBINCa PERMIT APPLICATION <br /> rypev}PreJacc _Now,�dAn Allernllon�Rcpair 7ypnofProjocL _NoW_,AdJn _AlloYallon__Ropalr <br /> ShawNumhor(a)u�llxlures ShowN�m�bcr p offlxhrrcs <br /> A/C—alr handllnp unils Toilet <br /> Forcadairs slams �a����0� <br /> Gas piFinn Lavalo wash hasin <br /> �y;��r,,r hoalor Showcr <br /> Gas freplace I<Itthan c6ik S dis sal <br /> Gn6�anqo Dishwasher <br /> Clothes dryer Clolhos w•ashor <br /> Rnnqo hood Watcn c�aler <br /> Erhaustfan Slnk sarvlwiborlmo letc. <br /> � —Neal pump—: Dackllnw provenler <br /> — Unilhoalor Urinnl <br /> �oller Drinkin{�FounWin I <br /> Rofdqoration Floot d�aln <br /> Wootlslove Greaso Imp <br /> ❑ucunq Roo(Jmtns <br /> 011ior Medicai Gas <br /> $pRINKLER/SUPPRESSION SYSTEM Other: <br /> Numbar ol Haads Oihef: <br /> I horony ceAly Ihat I have rwd and ezamined Ihis applicatlon and knaw the ssme 10 bo W o end covecl.A(I pravisiona of lavrs snd urainancas povoming <br /> tlJ,type oi xnrk w91 be cornplled v.ilh vAielher epodrod herein or rwt.Thn prenung ol n parmit eoee nal prasume m plve awhodlq to viotate or cancel <br /> ihe provision ot sny o�her e�ole a ior.a��aw repuleUng eonslrueUon ur Ihe pedormance af consUucllon.Tha[I am culhodzed by Ihe oxner of Ihl,propeily <br /> in wdaim Iho au�k for�wich appllwlion Is made and I compiywltli Ihe SWIe Conlractors Law 18,21 ftGW end 23G.200 WAc <br /> l .� 5-1^I a- <br /> Uwnc��AulhmizadAgent naluro Dele (Revised7/2011) <br />