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• --- • <br /> � PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGN/Si�RINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -A25•257-BB10—FAX 425-?_57-8857—vnvw.everelhva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 Pht Z•—I a� <br /> SITEADpRESS: DqOPERT'Taxp p- h��7 � <br /> 47o Dcc�,o4nE , <br /> LEGALIo•ner�wn:imcUo� SnodPlaUsabd��.ds��oo LcINo_ (atizch[opyollor.glegaltic<cdpGo�) <br /> OWNER �'/�O Phanc/E�Ra�i �2'�J' 3 —.�/�Q <br /> �aarcss 70J"� �E[AtlJH2E �'!�� ary�s�cerz�o �✓E2C-7T G�.1 �� 3 <br /> CONTRACTOR � 1 _ d–t{TL , L 8 I Lic k T �-}91{ � <br /> A�1�re55 I�' / �. � - Phone/F.:.�'oil 4��-J'��SI(�y�' <br /> TENANT BUS�NE55 NAh1E CONTACT FOR PERh11T a��i CUr� <br /> Phone�Fm2�����- <br /> BUILDING PERh11T APPLICATION CONTRACT PRICE OFWORK...�3i�I�.Gb <br /> Exist�ng Use of Buiid�a_ _._____.__ ___ HGAT SOURC[� <br /> Proposed Use ol Ciu�ltling___ ____ Gos Gie�Uic__ Otner <br /> �uiid�ng Iype X Smple I'amily _Dup'cx_Tormhouse _IAult��fam��ly __,Commerc�al � <br /> Typeolpro;ect _New _Addidon �Remodel Repaii_T.I _S�gn_Sprinkler_Demoti;ion_ Chznge o'Use <br /> Descrip;icnoflNork(addt.caz'spacec•v�dedo�fneback): /(�ED(f�� ��'I$Tj�l �AS �(.l2�/hCE U/(�} <br /> • /�� CrAS �U�n/stCE �N .5A'rnE LoCsi'f70n1 � �n�Qw Gi45 P/Pinl�- , <br /> Have you slarted worhing�vithout a permit9 .___YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBIIJG PERh11T APPLICA710N <br /> Type ct I'roJect. __Ilrw__AdAn ,�[�It�r.dion__Repolr Type o1 PfojecC `New__Addn _ Alteration_._Rr�p�ir <br /> Show Numbcr(C�o!LxNres Shovi Ilumbm(#)of(�xfures <br /> A�C-elt hr�ndlinp UNIs � 1011e1 <br /> _�——�—� forced air eystt�ms_______. _ ___�_ [lalhlub — _--—— <br /> Gas pip�ng � Lavalory p•�ash basln) <br /> � Watcn c�olcr j Sho:ve� <br /> � G25 4replacC -- -----�--�— � Kdchen:-.ink 8 A�spoc�nl --- <br /> � Gas range I D�slir�ash=! � <br /> � Clothe5 drycr � Clothes v�cshc� <br /> Range hood VJT;er heafer <br /> � Cxh;:ust Isn � Sink(servlte/barlmop�ett) <br /> � Hcat �umn � � OackLom ,mvenlcr <br /> UNt heiter Urinal <br /> L--______ -- _— <br /> � d0iler � Drinkiny Fountaln <br /> � Relrigern!ion Floor tlra'n <br /> Wootlstove Grease Ir,p <br /> pcctma � Roottlra�nr <br /> Other � htedical Ga: <br /> SPRINKLER !SUPPRESSION SYSTEM I otner. <br /> � � Numher ol Heads Other. <br /> I liereby cert�ry lnat I have read orW e.am�netl tlY�s eppDca6on enG kno��Ihe szme to be We anC wrrecl All provis�ons o�la�r,Bnd aE�nances Fovcm�ng <br /> • Nis type o�work wfil he comp6ed v.1N wfieNc�cpe:.i��ed herein or rot 7he pronGnp ol o permit does nol presame lo g�ve ouU,ority to violale or cance! <br /> ihe D��islon ol eny oU.er elale o�local law reguiaUnQ construd�on or 6�e FeAo�mance ol cansUudon That I sm euNorized by Ne e��nc�of this pruperry <br /> . lo pe Ue Nork for whic ppli lio ade and I wmply vAlh Ihe State ConVactors Lvx 1827 RCW and Y96 700 WAC <br /> ��.. �-��.� <br /> ' Ovmed thori:edAgcntSignay rc � r D te (Hrvfsed2QO1q <br />