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� � <br /> PERMIT APPLICA►TION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES �/—/�—/ <br /> 3200 Cedar St , Everett, W!1 98207 425-257-8810 FAX 425-257-8857 w�,nv everetriva or� � <br /> SITE ADDRESS: PROPENtY iNf N n^.tT e <br /> ,>l� Avr. . : , �-3 � - oa4-bo -� <br /> LEGAL lor new construci�on ShC:t Pla�"su�tlivl;ion Lol No (auacn copy ol ior��egai Cescr�pi��n� <br /> GWNER Phone/6mad <br /> �Oorc,s a 7 ,� S C.lylSlate2,p V <br /> APPUCANT: _ OvmC� Ov.neiSAqenl CeniraClor CoruaeloYSAgrn� _lenanli�-,��F�•��o+�err.rcromeni�.�c��nnc..ca�.oco..�,-�,.�,.�nes.:�xi <br /> CONTRACTOR O �v' Stafe L�c. a CJy Bus lic # <br /> adCress Phone/Email <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> � L I� (�' �0/v <br /> � <br /> PnoneiEmad - y'' (� tF �.,JL, <br /> BUILDING PERMIT APPLICATION CON7R4CT PRICE OF WORK = S�� �0 r' <br /> Ex�sting Use ol E3uiiC�ng��_��( HEAT SOURCE� <br /> Proposed Use of(iurtC�ng��� I { Gxs_ Eieanc__ omer__ <br /> BuJdmg h•pe� _Sing!e Famity _Duplea_Townhouse Mulh�Fam�ly _Commeraal <br /> Tyoe of pioiect Nev+ _Add�tion Remotlel Reps�r__ T I. _Sign_Spnnkler_Demoldion Cha�ge ol Use <br /> DESCRIPTION JF WORK(aae,tror,ai space�-c�-ieed on me�oc�:� <br /> 1 <br /> F�� t7 r'+� � � <br /> Ne u/ M � ���uN��< a � �,�xTu�eS QN�I � {��o� � A � G 3 �t �✓i�?`i <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typc ol Pro�ecL �New_Addn _Altetation_Repair Typo ol Projec�: _New_Addn vAllcralion_Repair <br /> Show Num6cr�b)ol li+tuics Show NumGrr(a)o/hrfures <br /> AiC -air hanal�ng um!s Toilel <br /> � Forced an syslems I Bathtub <br /> I Gas uiping Lavalory (wash bavn) <br /> Watcr heater Showcr <br /> � Gas firepiace I Kdchen smk 6 disposal <br /> Gasrange Dishwasher <br /> � Clothes dryer Clothes washcr <br /> Ranqe hoad j Watcn c�atcr <br /> Cah.ust lar� Sink ;service/barlmop/etc) <br /> Hea1 pump �a[h0ow preventer <br /> �{ Urn�hcatcr Urinal <br /> I doiler I Drink�ng founta�n <br /> � Refngerahon Ploor dram <br /> Woodstocc Grease Irap <br /> Ductiny Hool dra�ns <br /> � Olner N.etl�cal Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other <br /> Number ol Heads I Olher <br /> i I:ereOy<en�ly I�al I�ave reatl anE tean'.�ne�IO�e appl cnlipn pnd Anow I�e same to Ge iNe anC r0.Rc1 AllOrovisiops ol Ww5 anC orC�.nBnces gu�..ning t�ls lype o���ork will De comp)ed <br /> ��^n�,rnNhe�;p�nLce herem o�nJl The qranl�ng ot a permd aoes nol presume l0 9ive autnonly lo rmM•e cr canccl lne Oromsion o.'any elher slate or lowl law regulaling Conslmcben <br /> t��t i am aut�o..¢co Dy ihe c�ntr o�mis O�openy lo pertortn ine work lor xhc�apGM1uiben Is maCe antl 1 compty wnh It�e$lale Conlraclors Law 18 77 RC W antl 25G'<OOA N'FC � ^ <br /> � <br /> v <br /> �� ,�- I� �EIIy <br /> Owncr/AW onredAgenlSignatum Dalc �Reoisetl3/20i3) <br />