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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECNANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl, WA 98201 425-257-8810 FAX 425•257-8857 www.everettwa.org <br /> �22-1y <br /> SITE ADDRESS: PROVERTY 7Aff p PERMIT M <br /> loll Ca�(.� 1 - 5 <br /> . <br /> LEGAL Inr new consimcbnn. Short Vi�Usu�Urvismn LM No._ (atinch rnpy of lo�g legal desc�p4a�) <br /> OWNER �{le a'� P�onc�E-mad � • 1 p�j' � �p� <br /> Aa7ress ,Q � �OI C�ry/Slate?i0 ��felQ� �a -I 0�'�j <br /> APPLICANT:_Ownor _Ovme%sAgent _✓Conlraclur __ConlnctorsAgent __Tenantl�^�.�o�o.a�otne�o�ar+.n�mn.o.�noaown��n�wai <br /> � ` <br /> CONTRACTOR �0.Qy L :' UCU. ����p P -1� fI��OSZ Gry Bus.Lic p O�j Q,rj <br /> AaUress Q � � �VIIL(, �1VQ 1�270 Pno�elEmal 3�pQ '(p,�' ' �jOQ <br /> TENANT BUSINESS NAME CONTACT FOR PER�(ryj���T� <br /> JQ,Q_,fLa `UK-�--K.VlR�1'� <br /> PhonoiE-maA � • � -�.�� <br /> BUILDING PERMIT APPIICATION CONTRACT PRICE OF WORK �'�'�OO <br /> Ee�stmg Use of�uildmg _ ______ HEAT SOURC[. <br /> Proposed Use of Buildmg _____ _.____ ._ Gas � Elncinc Omer <br /> Bwldmg rypr.� �Single Famdy _DupleK_Townhnuse _Multi-Famity _.Comme�ual <br /> T c ol ro ect New Adddion Remodel /Re a�r T I. 9 n S nnkler DemohOon Chan e o1 Use <br /> DESCR�PTION OF WORK(ndedmner spncn pmvidn0 nn�hc Oacw1 <br /> (��� �u2na-� I.i.ke a,►1d kc.� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa o�Pro�ecl� _Now_Addn _Allaration_Repalr TyOe o1 Pro�ecl: _New_Addn _AMaration_Repair <br /> SAowNumDer N o/firfures S�owNumDer N a/Ilrtures <br /> A/C� ah hand6n unds Todcl <br /> � Forc�d av s slems BalhWb <br /> Gas i in Lav:�lo wash bas�n <br /> Wrter heater Shower <br /> Gas Rro laCo Kdchen sink 8 dis o5al <br /> Gas ran e Dishwasher <br /> Clothes A r.r Clol�es washer <br /> Ren e hood Woier heater <br /> [.haust lan Smk scrvicelbar/mo �nlc <br /> Nnat um BaCFllow reventer <br /> Unit heater Unnal <br /> Bodcr Dnnkm Fountnm <br /> Reln eration Floor Orain <br /> W oodstovo Grease Ua <br /> Duc6n Rool drains <br /> Other Medicai Gas <br /> SPRINKLER I SUPPRESSION SYSTEM otner <br /> Number ol Heads Othcr <br /> I nerc0y rertRy Inai I neve reae nnA c.aT�nea N�s ano''�wuon aoa Ynow Ne snm¢lo�e Iruc a�a mrmi I aV p�ovmm��ol L�ws a�0 o�C��ances govem�.nq 1�•s hM o�woA wie er romp <br /> vn10 wTBMef Spe[R�lE AeT��Oi n01.Thp 0�An4�4 nl B plT��EOBS n010�lS�mp 10 gNP BUI�OMy 10 vpl]t!O�UOf21111!plOVKqn 0109y OMC�SI01!0110fe1 Idw Rg�Wb09 CbOSfi�i�nn <br /> m eu v����avmci o�to pedo�n mc woM1 fa wh�rh appirtalv�maEn e�d I wmpN rrth Me Slale Conlrnctors I aw 1B 27 RCW anU I%700�W�C <br /> Own �i A gant5lgnaNre '�I Dat� (Rev�see9/70tai <br />