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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , [veretl, W� 98201 425-257-8810 F�1X 425 257-8fl57 www everettwa org <br /> APPLICATIONS ARE ACCEPTED fROM B AM TO 4 PM <br /> SITEADORESS: a , �` PNUPERTYTl1%11 PERMIT'tl ^ _ <br /> � �d !� <br /> LEGAL�or new construcnon Shon PiaVsub rvismn_,.________.____�ol No__ (i'�lar.h coDv o�long ieqa'Aes:n,tron) <br /> OWNER � PhoneiGi�ad <br /> Pddress �j.t oZ( � C��ty�SlaieZp <br /> APPLICANT. _Owrcr Gvrersl�genl Xe:nnlrar.�or Con!�aetotsAgcrl __ ,'cnanir^„ero�a.�aea'.nrra��eme,nur�nm.u^erioao.e����ineao��•i <br /> CONTRACTOR i�X� c�ls LY T� �g� �-'� � 6L / QI'� COF f3us L�c u <br /> Adtlress T��v�(� S. ������ �K(/ �GT(C PnonerFra�� oZ�p' p -3oL^Q pv� <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT�C 4� �°(�ySUH <br /> Phcoe�F�ma�i �L��' / / 3 ' �/-� /' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ _7,�Q _____._ <br /> EK�sling Use ol BuJtlmg_ �5. _ _ HGAT SOURCf <br /> Proposed Use ol�wld�ng r,as_____ f-iectr�c _ oiner_ <br /> �wltlmg type �Smgle Famdy __Dupiee_lo�++nhouse _f.lulh-Fam�'y _ Commercial <br /> 7ype of pro�eU New AdtlNon _Remodel �Repau_ t I _ S�qn S��ink�er_Demohi on_C��arc�e o!Use <br /> DESCRIPTION OF WORK (aCd�l�enal so�cce p�ov,0ed rn the bacHl <br /> yc t��!' l�T"+5U <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pro�ecC .__New_Addn _P".eration__Repair Type ol Pro�ecC _New_AdAn _Al�era�lon__.Repair <br /> ShOw NumEri f p)ol Grlurrs Show Num6rr(M)a(Ir.fures <br /> A/C -arc handlinq unAs � Todet _ _ __ <br /> I orr.cA au systems I F3alhtub <br /> �Cas P�pmg --- j I ava�ory(wash basm) _ <br /> '-- S�cwer <br /> Waten c�atcr � <br /> � Gas hreplace � K�tchen s�nh 8 d�sposal <br /> Gas rangc I Dishwasher <br /> Clnthes Aryer � CIoR�es washer <br /> Ran e hood I W��r,n c�aler <br /> Ezhn�sl lan Smk(service/badmopletc) <br /> Heat pump Backllow prevenler <br /> � Unit heater Uunal <br /> ❑oJer � Dnnking f�Cimla�n <br /> � fte(n9eralron � Fioor dram <br /> Woodslovr. Grease irep <br /> � Uuclmq � Rooltlrams <br /> Other � Metlicai Gas <br /> SPRINKLER I SUPPRESSION SYSTEM o�ner <br /> Number ol Heads Olhec <br /> I AereEy cerLly I�el I havo ieoO a��emm�ned�Ms apPbwi�on ana 4noN I�e s.�me�o Oe�me end mrrect Ail p�ons�.ons ol laxs end mCmance�gaw�mng t��s lype o1 em���/i�e cempi eA <br /> xn�w�ei�er spen6eC�ereln or not lne g��nbnq ol a permil Cocs nai D�esume lo qi�e aul�only to vioUle oi c.nael i�e pmvqion o�any ol�er s�ale or lowl iew regolalrng convmci�on <br /> Tnat i am aut�omed Oy t�e ow�ner o�mrs D�oO��Y�o FMo�n'�e woillor w��c�aDD°wLon b ma0a enU I rompry wc�tne SIaN ConbeUon Wx IB 77 PCW�nC 796 3004 N'nC <br /> �/e�s�7?���(���'���_� .. .o_. .._..�,, .�� <br />