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_ � - • <br /> � PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGlSIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett: WA 98207 -425-257-8810-FAX 425-257-8857-www.everetnva.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM - 3 —�Z� <br /> SI1E ADDRESS: ppoveqTv iax a p RhllT p <br /> � O �o z10- � 5 <br /> LEGAL lo�newconstvcnon� Sno4 PlatlsuCd•vlsror__ lo;No� (ettach copy of Icng legat tles:nGGonl <br /> OWNER ' S 2 �i t'ncne/E�maii Z✓.�y3��S <br /> t.dEress 3� C�ry/State2ip 2�Yr 98�- <br /> CONTRACTOR L&I Uc # <br /> AtlOres� / � /cJ �('^ .!L �,/�1/ � �d� P�,onelF.ma�l ���J- / �✓ ��/�� <br /> TENANT BUSINESS NAME CONTACT FOR PERh11T Do�A,�/ ��� <br /> U/-�l <br /> Fl�o-e'Em.-�:i ZJ�' �7/•S� <br /> BUILDING PERMIT APPLICATION CONTRAci PRiCE OF woRK 75.OD <br /> Ezisbng Use of�uildmg_ _ HFAT SOURCE� <br /> Proposed Use ot�ui�dmg__ _ Gas [iectr�- o;nca <br /> 6uild�ng lype� �S�ngle Famiiy _Duplex_Townhouse _IAuIU-Fam��ly ___Commercial <br /> Type of projecl�. _Nex ._Addil�on _R?model 12epalr__ _T.I.._Sgn_Sprinklei_Demolition Chanc�e ol U:e <br /> Des[ription o�Work(etldrtional epace piovidetlon fhe bacF):��5�-�L �'- �/�,�(� QNC'TL-ESS /(YQ 7- �L(�N� <br /> • S�KS%�'l.. <br /> Have you started working viithout e permit9 __YES (�[JO <br /> MIeCHANICAL PERMIT APPLICATION PLUMBIIJG PERMIT APPLICATION <br /> Type ol proJecC Nevi_AdUn �Alteration_Repalr Type ol ProJec��. _New_Atldn `Alteratian_qepalr <br /> ShowNumber(d)olliaYures ShowNumber(a ollixtures <br /> ft�C-aRhandlin units � ToiHt <br /> � Forced pir syslems � Balidub <br /> � Gas pipinq "---- �--�� Lavalory pvesh bosln) -- <br /> ___�_ Waterhealer _` �_ Sho�•;er <br /> � Gas 6repl,cc � � KltUien sink h disposal <br /> Gas rangc � Uislviasher <br /> _ _� Cbthes d er � Clothes washer <br /> � Ronge hood Waler healer <br /> Exhaust fan � Sink(senice/barlmopletc) <br /> f leat pump � ftackllov;preventcr <br /> _ l Unil heater __ _ --� Urinal <br /> � Doiler prinM��ng Foun(ain <br /> Relrigerahon Floar�rTin <br /> � Woodslove Grease irap <br /> � Doding � Hooltlrains <br /> � Othcr � Medical Gas <br /> SPRiNKLBR / SUPPRESSION SYSTEM Other. <br /> � Nu�mberolHea95 Other. <br /> 1�ereby cerLy Ihat I�a�e rea�en0 exzm�netl Iliis eppi,ca6on and Nnow Ue same 1�De ime anC correct.Ni pmvis�ons ol laws enC o�d�nances poverning <br /> lhis rype ol work vAll De complie�wllh wfiemer sFedfied herein or nol. The Bm�Gng 'e peanil Does no!presume to Pive euthonry lo violate o�cnncel <br /> • Ne provision of eny oNer slate or lodl law regulaLnB consWc6on or thu peAormar �of constmc6on That I em auMo�ieed by Ihe owner ol lhls propeRy <br /> to Fedorn Ue�wrk br which appl�w� aEe end I compiY N�N Ne Sta ConUa. ,rs Lsw 1B Y7 RCW nntl 296 200 WAC <br /> // <br /> /'0 3 Z <br /> OwnedA rizedAgentSlgna Date (RevlseC240fi) <br />