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� � <br /> F�ERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , Everett, WA 98201 425-257-8810 FAX 425-257-0857 www everettwa.org /� <br /> APPLICATIONS ARE ACCEPTFD FROM 8 AM TO 4 PM I �- 3 I �I 7 <br /> SITEADDRESS: I� C ( � (� �0' PROPERTYTA%p O OO P RMIT � <br /> O I� � <br /> LEGAL fo�new constmc;�an Short PIaUSubarv�sion Lot No_ (attach mpy o1 IDng Icga�ticunpbOn) <br /> OWNER e a I O (/�/ • Phone�E�mau �V TC <br /> Aatlress � � ( yy� Gty�State/Z�0 IU /� W ��s <br /> APPLICANT' Owner �,Ownef'SA?2nl ConitaCio� Co�iraC70r5Age�t ie�dntlm.s•c�o.�ceaienoc�m-.�er�nenreo�.-e•inaow+e �cwspacnl <br /> CONTRACTOR�• L 8 I Lic tt COE Bus Lic rt <br /> �ddress �noneiEman <br /> TENANT BUSINE55 NAME ' ���pn 1 K �3 CONTACT FOR PERMIT /�S Cr �� C� � S44L •I) <br /> e�v I <br /> Phone�6ma�i �r J C�� V [ G ��M <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �� <br /> Ewst�ng Use ol Butld�ng HEAT SOURCE. <br /> Proposed Use of BuJtling Gas_ [iectnc Otne�_ <br /> Buiidmg type _Smgle Famiry _Duplex_Townhouse _MWU•Family X Commeraal <br /> T e of ro�ect. New x Atld�t�on Remodel Re av T I. S� n S nnkler_Demol�tion_Chan e ol Use <br /> DESCRIPTIONOFWORK(adddm.�aispacepro��deaonmebac�9 il�nlAu C� ex15 ll� � /��[A/�p( yJl t <br /> ��� s�u� u� ��,s . Qda a czRas` u�ih d a�:� Pr� k��+�s� 3r�n{� <br /> uni�� �nd t ln IonJ co6lc « lanj � p�oJfJ ro�o�}o ullrik . <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pmjecl�. _New_AdCn _Atteralion_Repav Type ol Pro�ecl: _New_Adda _Alteration_Repair <br /> Show NumDer(p10/fixiures Show NumDer(aJ o!fixturps <br /> FVC—a�r hanahn unds Toilet <br /> Forcea an s stems Balhtub <br /> Gas ip�n Lavalo wash basin <br /> Water heater Shower <br /> Gas irce lace Kdchen sink 8 dis osai <br /> Gas �an e D�shwasher <br /> Clothes tl er Clothes wasner <br /> Ran e hood Water hr.ater <br /> E*hau51�d� � ' Smk serv�ce/bdr/mo /ftc 1 <br /> Heat um " Aackllow�:caenler <br /> Und heater Unnal <br /> Bodcr DnnWn Fountam <br /> Reln erahon Floor tlrain <br /> IWoodstove Grease tra <br /> Ductin Roof drains <br /> Other Metlicai Gas <br /> SPRINKLER / SUPPRESSION SYSTEM otner <br /> Number of lieatls Other <br /> 1 nemoy cen�N mat I nave rcaE anE eaammea m,s aC���U�ner,aoG Mow Inc same Io�e we ana tunen nu pmvis�ons al laws anG om�nantes govemmg In�s ry0e o�wo�k wni be wmol�ea <br /> vnin w�el�er 5peuhe0 hemm or nol TTe graning ol a Oertntl does not pmsume to 9�ve aulhon'y lo a�piate or p�ncet t�e pTvrsmn ol a�y al�er stale or iowl law regvlaLng cnnslmct�on <br /> TTat I am aoi�o�xeU Oy Ine owner ol l�is pmpeny lo pertnrm f�e won�lo�wmU+app:�wiron u maae a^a I compy wu�1�¢Slele Lonlreclors Law 1P:1 RCW ana 296 700A WAC <br /> —��A S�/t _�- i�ir I�y � `+(a <br /> Own dAulhorizetlngeMSignature Dale (Rev�setl6?072) <br />