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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � _19 '/ <br /> SITE A�D7DRpESS: /� ,/ PROPERN TAX u ERMIi a <br /> �.3� p l)Ioa.J� �� ��<.�*� �� �7 � Z0 � CG4S�145402YGG O 'L <br /> LEGAL lor ncw construclion� Short PlaUso�tlnision Lot No (attach co0y ol long legal Oescnpt�un) <br /> OWNER 1�-,..-� L �,� ���.� � ��«,.,. _ C � L P�onc/LmaJ YGT- zS1.v3sS C��•�� .. -C'. ... ! . <br /> AC�rcSs a 3 / Fj � i,��,,y ti� Cily/Stale/Zip �e c!c f�- wA �7 Q Q p � � <br /> APPLICANT.�Ownef OwnersAgeni Ceniractor CorDac:er'sAgert 7enaMi.T,sicv�.coai���o�oiur�se�i��ome�.eo..����>ee.o•�-��r.o�oa:.�� <br /> Ja� /� O- <br /> CONTRACTOR CS 5� �✓�� K�._ i 1��o�t. l& I L�C # �FOP�CS DL�.OE Bus L�C # <br /> tiaa�rss 2 3 DI C ��_ $� E+..,�( //a Qy c; c PhoneiEmail y1s 3 �i 3 - �ry c <br /> TENANT BUSINESS NAME � �y-����(uS'�l11 S�1' � CONTACT FOR PERMIT � <br /> .11 � a , I `11i 1s7'' <br /> E �. r . V�� � _ ,._ Phone'F�mad ✓�'�.J l�o n a y 3 5 � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exist�,n� Use of Bu��ltl�ng HEAT SOURCE <br /> Proposed Use of E3wltling Gas [iectric otner <br /> �udding type: _Single Fam�ly _DuDlex_Townhouse _�dulti-Family _Commeraal <br /> T De of pro�ect New Add�hon Remodel Repair TJ Si n SDnnkler Demoh6on_._Charge of Use <br /> DESCRIPTION OF WORK laea�t�onal space pro��dee on tne back). <br /> �-F�' I< � /9 �- 9 r r f C a r ��.. ,'c � <br /> ��ot� 7�. � � , � �P � <br /> ��, s ��,��� ��. � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol Projocl: _Now_Adtln _Alteralion_Repair Typo ol ProjecC _New_Addn _Atleration_Repav <br /> S�ow Number(NJ ol!ir(wes Show Numbcr(al ol!ir fures <br /> A/C—air hantlling umts TodM <br /> Porced an systems Balhtub <br /> Gas p�p�ng lavalory(v.ash basin) <br /> Watcr heater Shower <br /> Gas 6replace Kdchen smk 8 disposal <br /> Gas rargc D�shwashcr <br /> Clolhes tlryer Gothes washcr <br /> liange hood Watcn c�ater <br /> Gxhaust fan Sink service/badmcpletc � <br /> 11eat pump 6ackllow �reventer <br /> Urol heater Urinal <br /> Boder Unnkmg Founlain <br /> RMnceration Fioo�dra�n <br /> Woodstove Grease tiap <br /> Duct�ng Roof drams <br /> Other Metlical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other <br /> Number ol Heads Other: <br /> I here�Y ceridy Ihat 1�are rca!an0 e�amineG 1�6 eGpbwiion an0 Anow Ihe samo to Ca I�ue a�tl tArteC� All provis�ons ol laws anE ord�nances goveming I�is type ol wDrk wi�l Ee tomp'md <br /> wd�vrtici�er sDeuGea�ereln or noI T�e g ranbng ol a pertnA does nal presume lo g�ve eu��onry lo noiale or cancet t�e pmnsion o 1 any oNer slate or local law regulavno wrewction <br /> Thal l am aulhodxed by'I�e onner ol i�is DroDerty lo pedortn tne work for wt�rch appuwi�on is ma0e and I compy wtlh me Slate Contraclors L aw 7B 27 ftCW ana Y96 700A WAC. , <br /> �, � <br /> //� <br /> _,/.,�� /� ����� .��v���__ �« �� �� � � 5 <br /> OwnedAu�borized Agent Signaturo Dale (Revised 6/1071) - <br />