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PERMIT APPLICAtION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-9810— FAX 425-257-8857—www everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM e AM TO�PM <br /> SITE ADDRESS: �`� 7NOVFRiY TNI N E J�x�_ <br /> S/JS Crf/NouK v L(1 <br /> LEGAL fa new oonshudron Short PlaVsubdrvis�on 101 No_ (atlad�mpy ol long Icgat Acxnption) <br /> OWNER �/YI I/_ WnJST.J.(.�C_r7 c�i�J PhonPlE+na�l y�r • �-�v - C�Sti I <br /> near�s5 OO gdr �7-o Z7 Crtyl51ale2�p L✓✓�7I7I.t�7T wA '�b�2v(, <br /> CONTRACTOR .R�r�S��.v �Lum i /tie., L 8 I Lic M i� /ti/� +� 27LL Z <br /> /N�1 <br /> edress � 933� �3-Y!'� •4✓C NE A'X�-r�v� 7'dnJ Phon�JFinad .�LO—YU3 �46'L . iG. ,c�Jryr <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 'L�7J �Jb'/NJu.aJ � t3-Jh S�.r t <br /> PhcndLmail �,/ •7VL.� <br /> BUILDIN6 �ERMIT A�PLICATION CONTRACTPRICEOf WORK �.�s"'�)[� <br /> Existing Use o(Building _ HEAT SOURCF <br /> Prop05¢d Use ol Building S FQ Gas Elcclnc Olhr.r <br /> Awldmg type� ✓ingle Family _Duplex_Townhouse _Mulh�Famdy _Commerual <br /> Type ol prqed� _New _Adddion _Remodel ,^Repav�T I _Sign�nnkler�Demoldion�Change oi Use <br /> DeSCnp�iOn OI WoAe(adddronel spece pmvidM on�he Dnck) <br /> Have you sUrted working without a permlt7 _VES ��NO <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> i Type ol Pro�ect: _New_Addn _Alleratlon_Repair Type ol Praec4 _New_Addn _Alleratlon_Repeir <br /> SAow NumDer(NJ ol firlures Show NumCer(M)ol/lnums <br /> AIC-au handlin unds Todel <br /> ForCCd au s stems Balhlub <br /> Gas i m Lavaloi washbasin <br /> water healer Showei <br /> Gas 6replace Kitchen sink 8 disposxl ��� <br /> Gas ran e Dishwasher ���, <br /> Clolhes d er Clothes washcr ���, <br /> Ran e hood Water heate� I <br /> Exhausl tan Smk(serncelbarlmo �etc I, <br /> Heal um fSackllow reventcr '� <br /> Und heater Unnal <br /> Boilei Drinkm founta�n I <br /> Reln eralion flnordinin � <br /> Waodstovc Greasc ira <br /> Duqin Rool Grains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Otner <br /> 3� Numbcr of Ncads Other <br /> I hemby rnrtl�y Ihal l have read and eiummM tlus aDW�Glion and know Ihr,xame to bc truc e�d mnetl NI O�ovivons ol laws and o�dmanu,•s govrmmq <br /> ihis tyVe ol wpk vnil be cvmDlied witli vA�ether spmM1eA herwn rn nol Thc q�an6ng ol a�N:rmA dces nM qexumc to qne autlnn�y to violalc or ranccl <br /> the provivon ol any olher slate or Inc�l law ngulahrg mnsUucLon oi thr.pr.rfirmanm ol ronstruction Thnt 1 am aulhonrtd Ay Ihe wmer ol Ihis propr.M <br /> b perlortn Ihe wvrM lor wfiirli applrauon Is made and 1 mmpiy v.tth Ilie Slntr.Cantrarfors Law IB�7 RCW anA 796 100 W�C <br /> �C�,�I/ 6,/�r/� <br /> OwnorlA o ze0 A Signatum Uatc (Hr.nsed 7R01 Q <br /> �(Z <br />