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PERMIT APPLICATION
<br /> BUILDING/MECHANlCAL/PLt1MBINGlSIGN/SPRINKLERIDEMOLITION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3?_00 Cednr St., Evcrett, S^JA CEt?_01 - �17i-2:i7-Pf310 -� PnX•S��i-257-fi8il- v.�•::�.c����rcthva.org
<br /> APPLICATIONS ARG AGC[PTED FROL7 8 AM TO 4 PM
<br /> SITC- A 0 SS' fROPLHIVTA%u PCRAIIT
<br /> .��o� ��oe�pu� ;�E y• �i��' ^ 12 - �Co2
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<br /> owNeR �MC'✓a!�!r:lorW l�UfAJG ��2u5r _ ,=�,,�F- ,;, y?�- 3YS-G0�4 —
<br /> ACr,re.t �.�. ?� ��,Y;>,.a�;.�;.,: MA��c{Su� IIC �f.�� 7 U z7�
<br /> CONTRACTOR Ly��� � �1 ��� / I..S I I i�:.t1 C'V�f� G22Dt'
<br /> ..�.�.,.,.; ��� I '� fl � D�U� rr, , r .,.:i �j"L�2'3� I�
<br /> T[��ANT OUSIIJESS NAh1E CONTACT FOR P[R�d1T MAii.l�-(��/>'��:C'�"'
<br /> ,eadl� B ,hnt� ucs ���-.. :-.�-:,. z -Zsz-3�j4
<br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF LVORK .�-1 GU
<br /> _. .;�-�usecruu�n e ._ 0 CNra�Gr ____ rie,�rsruace:
<br /> �,.�;:cccJL'secf3ulCmg 7�0 � C�1�4i���`�. . .. ____ — 6::; �edn- C.;�,�.. ._
<br /> 13u ilrgly�pe�. _Singlefamily _Du(i.ex__lev:n'-._::s: __Idaiti-Fan'�'/ X Ccrnmcr��nl
<br /> ' ;.;,of p:ojecl: _kew _Add�ticn _F.emc�'N �C f2rpalr_i J._S��n__S,,-�n�;er _Demdnl:,n_Chan,� ef U;e
<br /> i��;::�.:iiptiun cf lNork�;,J,;"nvai�.par.e previden�i ti;c C.i,:;l�.
<br /> �� £�t-�-�L FJ4tJAC�i
<br /> Have you started working without a permit7 __ YFS _k NO
<br /> MECHANICAL PERM[T APPLICATION PLUMBING F�ERMIT APPLICATION
<br /> Type ul Prej�cC _New_AAtln _ Altcration__Nepair T�-pn o1 Profecl: _New_Addn _Alteralion_Rrpa�.r
<br /> Sho.v Number jdJ ol li+fures Show Numher(k)ol lirhues
<br /> A;C-,ri harChng nrnt: Todct
<br /> Forr ed 1�r sydmns Halhlub
<br /> Gas���,mg Lava�nry(v:ash basin)
<br /> �1JnI�.r hna!er Shov:er
<br /> Ga 5 lui•plar.c Kdchen aink R dispo5al .__
<br /> Gas mng0 Dishv:ashor _
<br /> Clothns dryer CIo1h�.s washer
<br /> R�n,o hood lh:ilei hnat�r
<br /> Enhnu,t lan :ilnk(scrvicr/bar/moplelcJ
<br /> Heat pump Oackfuw p�eventcr _
<br /> Und heater � Urinal
<br /> Botler Urinkin�Pounta�n
<br /> -- � �� Refnqn,rihrn Floorcfaln
<br /> V'oodsto�;o --� GroaErt Irap
<br /> __ _—� Uur,bn3 _ ____- ___ HnofCrnins
<br /> I Olher IAediwl Gas
<br /> SPRINKLER I SUPPRESSION SYSTEM O�her:
<br /> INmnh.-rolHc�r'..� I nlhee
<br /> �horchycc:ldylnallh.:�eu.aJ,�mlc,:mrn��dlli5r.p�L��.r:er,u,]�r.:,:�IP ran�:eWbc:weandeorrCCLAllpmv:uiunsollavrsandordinantcsgoveminy
<br /> ih�s typo ol v,mk v.'.II be comN�cA v:Ih nhcther,per.il:etl I�.oro'n nr n,-•t.I he cr:uibng c/a pem�it dxs not presumo to g've aulhotlly lo viotate or eanr.el
<br /> iha provisi�n nl any olher slaie or Iocal law regulating con5 Wd�on or R��e pedcrmance of wnslrucLon.ihat 1 am aulhorize:by Iho owner ot Ihis V�opetly
<br /> ��!o p^d Ih��work fcr vRiich np�9ica�ion is made an01 comply vnih Ihe Sla;r,Ccr,lrac:as La•.v 18.77 RCVJ nnd<"9"u20J 4'JAC
<br /> � 12—��� �
<br /> Q�'Au ari fAgeMSignaturc O�'a �@..��:z-�i37U71)
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