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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Fverett, W� 98201 425-257-8810 FAX 425-257-8857 www everettwa org <br /> SITEADORESS: PROPFRTYTN(p P MiTa U <br /> 7�� F �C1L�v.t��Z['��. "�S' . �—� ' I.� <br /> LtChL Im otw construcuon ShoM1 PlaVsu6drv�smn___ __�ol No_ I�IIaU copy ol long iegal descnplionl <br /> � <br /> OWNER � � Phone�E�mad <br /> Address GlylSta�e/Lp <br /> APPIICANT: Ownei Ownersngenl Convacio� Cum�actorsngent Tenant��.n�,���cora�����iw^��•^�����^No:.�e��.oc�.o�.,�vosco�ei <br /> CONTRACTOR Slatel.�c kI V Gt ��s Lic W <br /> y.�5-3�6-391`� <br /> AUtlress � y�� � Pnone'Emad ` . ' <br /> TENANT BUSINE55 NAME �h—�� \\�1 _ \__ CONTACT FOR�PER•�MI.��� ���_-��_�c'�e� <br /> �`��J►p,�V 1 <br /> c�idcv� �- � i� K� �s " I�n� � PhOnP�[ mad � <br /> BUILDING PERMIT APPLICATION coNrRncr raice oF woaK____Q��_ _ — <br /> Lxisung Use o�[3udtling_�=r.�_�_ _ H[�T SOURCG <br /> Proposed Use ol Bwitlmg_����gc+��s.� C-r���1 � Gas Eiccmc� Otnci_ <br /> Bmldmg�ype _S�ngle Famdy _Doplea_Townhouse _.Mulh-Family y�Comme�nal <br /> Type ol pro�ecl New AddiUon Remodel Repa�r_ T I S gn Spnnkler Uemoh!ion Change ol Use <br /> DESCRIPTION OF WORK�aom?c��;:cace e'o��deo o��rne�ocw� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pralect: .__Now_Addn _Alteretion_Repalr Typo ol ProJecl�. _Naw_AEAn _,Altoration_Repalr <br /> Shaw Nom6er(p ol/ratures Show Number(MJ of/nfurns <br /> AiC -an handhn units Todct <br /> � Forced air systems 13a1h�u6 <br /> Gas p:piny Lavatory(wash basai) <br /> � Water healer i Shower <br /> Gas I�iuplarc 1 Kdchen sink 8 disposal <br /> � Gas rangc ; U�shwasher __ <br /> Ciuthes dr ei i Clothes washer <br /> Rangc nood _ ; Waten c�ater <br /> � Cxhaust lan Sink�serv�ce/t�ar/mop�etc 1 <br /> Heat vump I Oachllow preventcr <br /> Und healer Urinal <br /> tloiler Drinking foUnl.m <br /> Heln craUon � Flooi dram _ <br /> WooAstove Grease tiap _ <br /> Uuchn � Roo�drams <br /> j Other � Med�cal Gas _ <br /> SPRINKIER I SUPPRESSION SYSTEM I OOier <br /> NumbPr o�Heads Olher <br /> I r�e��[�y�rrt lr��.�I I ne,r iead an9 c�an,n-�pi,.r,.pxc,f vn.md�now I�e same�u Le!�ue a�+4 ce�recl A I p�mnrons ol lans�n�oN�nan[es govem�ng IM IVC ol worh v,i i pe romple� <br /> w�•�xhr�9vi saeuDeO nmrm n„�ot mn g�ani ng cl o C�rnut�bes re�Cresume'o 9'��e ou�n��:lvlo wc�aie m cx��rel me C�om�n�ol an�oinei flale or local I�w i ��In�np mns�mrLnn <br /> l�ol i n�i auTa�i:ea E�i�e oa��n o�inis pmD¢�y t0 Gerto�rn In�woi�lo�H^�c�appi�ca'�o���s n�afe nn�i m��py wm�Pe S�aie ConnaCe�s lax tP T)RCCIa^d d9G:OCA 1'1�C <br /> �V . ���Q7�M1..�. Qa/LV�-- �Feased 1:017) <br /> OwncrlAuthon d Agont Slgne�urc ���" <br />