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FERMIT A'�PLICATIGN <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-6857 www.everettwa.org <br /> ,,al --I <br /> SITEADDRESS:�� ���'��y PROPERNTAX77 P RMIT —O O <br /> LEGAL for new wnsiruction: Short PlaVsubdivision Lot No._ (attach wpy ollong legal desaiption) <br /> ON"NER /Y/i4if.l� �G�i(�D Phone/E-mail 3GD �G9Z' ���8 <br /> AdOress 32Z0 �iGO.fOL✓AJ� CitylState/Zip ��..,7�,�� /.�/� 98Zo/ <br /> APPLICANT: Owner OwnefsAgenl �Contraclor Centraete�sAgent TenaN�m�.iproraearoverc+oo,se-i+�omu��.oermaowoM�,mesca:el <br /> CONTRACTOR Y'�TiUDT �Op/•'/N LL� L&I Lic.# ���v_/,GG36 �G COE Bus. Lic.# <br /> Address �� aOX /9G7 �+7�6 y��� �✓t �J'833Z Phone/Email ZS'�''ZG�G�I-� <br /> TENANTBUSINESSNAME �_Pfeu CONTACTFORPERMIT <br /> , PhonelE-mail �.J.�•ZZS-�933 V767.�(�pGOfaCK <br /> BUILDINGPERMITAPPLICA'f10N CONTRACTPRICEOFWORK <br /> Exisling Use of Duilding HEAT SOURCE: <br /> Proposed Use of Building Gas Eiectnc_ O�her_ <br /> Buiiding type: _Single Family _Duplex_Townhouse _Mu�ti•Famity _Commercial <br /> T oe of prqect: New Addition Remodel _Reoair_T.I._Sign_ Sprinkler_Demolition_Change of Use <br /> DESCRIPTIONOFWORK�adc'itiona�spaceprovfdedontha6ack�' p_ovE Z �yrs�,3 �f ��✓�S A� <br /> l•v1�cc � ��rc� a,� �.vyc.�- ���o. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> typo ol ProJect: _Now_Addn _Alterallon_Repalr Typo 01 ProJocl: _New_Addn _Alteration_Repalr <br /> Show Num6er(q)ol lixfures Show Numba pq ol Iixtums <br /> NC—air handiin units I Toilet <br /> Forcedairs stems Ba1Mub <br /> Gas piping � Lavafory(wash basin) <br /> Waterheater � Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gasian e I Dishwasher <br /> Clothes d er I Clothes washer <br /> Range hood i Wal2r heater <br /> Exhausl fan I Sink(service�bar/mopletc.) <br /> Heat pump Backflow preventer <br /> Unit heafer � Urinal <br /> 6oiter � Drinking Fountain <br /> Refrigeration ( Floor drain <br /> � Woodstove � Grease irap <br /> I Durting I Roof dreins <br /> � Gther ! Medical Gas <br /> SPRINKLER/ SUPPRtSS10P1 SYSTEM Other: <br /> Number of Heads Olher. <br /> I here6y wrtAy Ihat I have reaC and '�eC Ihis applicalion end know the same lo be Irue end corred.AA provisions ol lawe and orOinencee govem�ng this typa ol work vn'I be compbetl <br /> wllhwhetherepecifKdherolno oV���fhegrantlnpolapertnAOoeenolpreaumetoqiveaulhomyloviolateorcanceliheprovielonolanyatherclataorlowllawr!pulelinpmnctmetion . <br /> Thal I am authurizeJ�y Ihe �roperty to pMorm Ihe�wrk for whic�epplkafon is maEe an01 comply w��I�e State Contractore lew 78 27 RCW anA 298.20CA WAC. <br /> / y. <br /> � i <br /> /!�/�;�� 3y� i3 <br /> Ow IAuthodzod A9ent,SiC�naluro Date (Revisetl3R013) � <br /> I <br />