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PERMIT APPLICATION <br /> BUILDINGIMECHANICAI./F�LUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl,WA 98201 425-257-8810 FAX 425-257-8857 www.eve.ettwa.org <br /> APPLICATIONB ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE.IDDRE55: ' PROVER N( P NMITM <br /> 2 �� c«5 , ���; ��� � ���, r?o�� < <�G �� � � - <br /> LEOAL/or new wnstmctbn�. Short PlaVfu�Civision Lot No._ (etlech copy ol lonq iepal Cesnptron) <br /> OVYNER � lC�i 1E_ � `• \ �! Pnone/E�rtwil �CF'— yL'(p— 02 �' (� > <br /> � I � <br /> Edreea � �� r� �J� �����1 CityiSlete2ip �) L <br /> APPLICANT:_Ommr Owner'sAqenl�Conuactor Contractor'eABanl Tenanl(�no�o.aum.oimn•m�omn.wn«maown�mm•�o«.1 <br /> CONTRACTOR �� ��.� C C n` � u. i o�i L�—�-- L 8 I Lic.p ��v' � L �1 D ' WE Bue.Lic.N <br /> dErea� � ��l ' �(.r�l�� �7L j�..� � NIILdLU[� CJ�I PMne/Emeil �) ' 9�' ' � 2.� Z <br /> A E CONTACTFORPERMIT ���C ���/� <br /> L 'lC(c iG`I,-S� �G /� <br /> �� b. l.��� l�u��,v�c. �I •-� S �- �--�--- P�one/E�mail q �J �l. '�-Q � 0 <br /> BUILDIN6 PERMIT APPLICATION CONTrtACT PRICE OF WORK <br /> Existing Use of Bwlding HEAT SOURCE: <br /> Propoeed Uee of Building_ Gae Eieanc Otnar <br /> Buildi�g type: _Single Femily _Duplex_Townhouse _Multi-Femily _Commarclal <br /> T e of ro'ecC New Addition Remodel Repeir T.I. Si n S �inklar Demolitl.,n Chen e of Usa <br /> DESCRIPTION OF WORK(atlditionel speca pmddetl an Poe Decw): � ��1,., �. � �" S< <'PE' <br /> f L'l Yta,��n 1 <br /> C�-{- �. c�� k I� �ct� i ��c` � �� �� i � i�TD� wca l�� Cv� c� �c.l�."'���t`'` eIcY.T. <br /> J <br /> � /�r�� / L- � 17 O -� f. � C (�, l� i [�. � j <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProJacl: _Naw_Addn _Alterellon_Repalr TypaolProJacl: _Naw_Addn _AltaraUon_Repelr <br /> Show NumDer(g ol Ilrturm Show Number(N ol lirfure� <br /> NC—air hantllin uNis Totlet <br /> Forced air s stems Balhtub <br /> Gas i in Levato wash basin <br /> Waler healer Shower <br /> Ges fire laca Kitchen eink 6 dis osal <br /> Gas ran e Dishwesher <br /> Clothes dr er Clolhes washer <br /> Ran e hood Water heater <br /> Erhausl lan Sink service/bar/mo lelc <br /> Heat pum Backl�ow revenler <br /> Unit heater Urinal <br /> Boiler Drinkin Fauntain <br /> Relrl eration Floor Crein <br /> Woodslove Grease ire <br /> Ductin Rool dreine <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Olher: <br /> Number ol Heads O�her: <br /> I I�ereLy certM�het I hem me0 a�U emnimed tlu:opflqeton eM Ino.v I�e�eme la Ca Irue enA corted All pmvh�Mf ol kwf anE ordnencn pwemHp Ihb typa ol xaM vAI Ee compleO <br /> w�l�wimther speaMA�emin a not.l�e p�eniinp ol e Oemul Eam nol prmume to pve euNorqy�o Nobte or cance�Ihe proNabn Weny oNer tlele a ioul Y�wrepubtMp corobuclion <br /> l�ot I nm eutlion:ed�y I�a aw�er ol qb O�oPeM�o perlorm I�e work la w�kh eppkebon h meEe enC I comph M�I�e Sble ConUrtton Lrw 1B]7 RC W mE 38B t00A WAC. <br /> ��j� ��? ��/�r-� /�/�/��a I I� <br /> Ow�ferlAulhotlied Agenl S�gneture ala (ReviseC N70I2) <br />