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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , Everett, WA 9d201 425-257-8810 FAX 425-257 8857 wv,nv everetiwa org <br /> SITE ADPRESS: PROPFRTY TAM 11 PERMIT f I <br /> / �,o �vr.utl wa �o G o0 0 � o <br /> LEGAL lor nr.w canstiu<;ion Snon PiaU.ubO�v�smn I.ot No iatiach co�y ol lon9 Icgal acsu�plunl <br /> OWNER 1 �Q��/pYo'$ Ce6v�hcenna W��one�6matl p? ' � 7 <br /> Ad�rpss � P � Cdy151ale�LD �'1'7Qn([ y.�/r 98e <br /> APPLICANi: ✓Ownei _ _Ownrr'shgent Conl�aclor _ ConlraclorsAgenl ._Tenant�,rm�;:Ya�� .�e��i«�u-��r����.•.��.���n��m.�+��n.ur�i <br /> CONTRaCTOR vy Stale L�r. JI Gt tius I.ic x <br /> 4ad•ess PhanC!Email <br /> TENANI BUSINESS NAME CONTACT FOR PERMIT <br /> �n+anda C�C6rGha n n�, <br /> ��„o���.�,�,� yas 3�9 - � <br /> BUILDING PERMIT APPLICATION CONTRAC?PRICE OF WORK 2,zS�_Q_� <br /> Fx�sling Use al(3udding_�(5jl/_�___ _ � �Iji HFAT SOURCE <br /> Proposed Use ol Ou�itl�ng /`���� ' � _ �/ Gas_ Eicanc '� Otne�_ <br /> flmldmg lype �Singlc f amdy _ DupieK_Townhouse _ It��Fami _Commerual <br /> Type ol pro�ecl New ' AdOition Remodel Repav T I Sign_Spnnkler DemoLtion Change ol Use <br /> DESCRIPTION OF WORK�a,�r.r:nai soace F�����pd on�no Cacw <br /> �.) Aa�d,�y ..�n�ale�o,r ro,np �o t�jris��� du,,e en b�e,r nf hcNs�. <br /> ��LVh�ncr r� 'cd� ;f K,fc�7in a �io'� � rrpla_�c,_�C�h�tiPn S,�K � <br /> Sherrtr Y'�l��ns <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol Pro�oc1: _New__Addn _O,Iteratlon__Repalr Typo ol PioJocl: _Now_Addn _Al�eration�_Repalr <br /> Show NumDcr(Ml o//i�fums Show Numbm�M)o!/irtures <br /> � NG � a�r hnnAl�ng unAs I Totlet <br /> Porcetl a�r 5istems � f3aU�lub <br /> ' Gas �pin ; 1 av3to (wash 6asm) <br /> i Water healer 1 � Sho�rer <br /> Gas hreplace � Kdchen sink 8 A�sposal <br /> I Gas iange I UisM�nsl�er <br /> Clothr.s dryer � Clothes washer <br /> � Ran c hood ' Walen c�atcr <br /> L■haust fan Smk�scrvicc-banrnop;ctc) <br /> Heal pump � Backllow D�eventer <br /> Urol heater i Urvial <br /> ' 13oiler i Ur�n�ing founlain <br /> � Hehi erahon i Floortlrain <br /> Wootlslove Creasc Irap <br /> DucUng ; Rooldra�ns <br /> Other � Med�ca�Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I oine� <br /> Numbrr of Heads i Olher <br /> I�eieLy ttn!�I�,�I�m�e reaJ;ria e uim�netl R�s npF§otlmn ar�AnuH IN iame to Ce ime nnC co�mtt PA provoio0f ol l,ir,s en0 o•]:�nnces goreming Ihn ly�e ol woi�n'I De ce��i e� <br /> M�'�N�fl�fl SpnOfiCd OMHn U��CI Tp<g W n�ul9 U�J pCT1A dJtY fl:l VCSUT¢IL`SiyC dd�Cl:Y IC VNI�I!OI W�CCI IPC QlCvif U��0�d���P�lI Sldl[O1 IOW I IJN Ip911d9�p C�PSIIO�1rOp <br /> lna•Iama���onic0��l�eo-enrrcllnsp�cpenylnpeNerm�nenUrlb�w�¢�apCi�<alon�smaned�ClwmplyNilpine5�:neCOMranonlawt9iiRCVlan�i9tiN.JAI\AC I <br /> ��l��—. 9��; � Z <br /> OwnMlAuthorfzatl Agonl Signalurc Ualc lRev�sc9 3?0 f]) <br />