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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425•257-8857 �waw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � —/,$� � <br /> SITEADDRESS: VROPERN7AXp P MITY <br /> zis� d oio t r o 00 - 03 <br /> LEGAL lor new construc6on Sn�r1 Plal/su6diviscn Lot ho._ (attach copy ol long legal Cescr�otion) <br /> OWNERL'i o�F£uer c. d 1��- PhonM6maa y2! Z� j S <br /> Adoiess `� to �j CitylStalelZ�p fVtfe � Lf�� �O <br /> APPLICANT: Ouner xO�vner'sAgent Comraclor Cor.IracloYSAgenl 7enani�mmie�c,�eea��nuacc,«mrto.,mam.•+=�ma,»oa�m�+w�n <br /> CONTRACTOR /3 s ` C L 8 I Lic # COE Bus L�c. # <br /> ned�ess PQ �,p e �noneiEmaii Z f 3 -N7f" 067� <br /> TENANT BUSINESS NA E CONTAC�SSPcERMIT� 4N`� <br /> q�e ��Lt� J s <br /> UR. n anoneiEmai� �125' 2. � 7 — 7 y' <br /> BUtLDING PER IT APPLICATION CONTRACT PRICE OF WORK 3f 3 O .Od <br /> Exist�ng Use of Butltl�ng HEAT SOURCE <br /> Preposed Use of Owiding Gas_ Eiectnc_ Other_ <br /> f3wldirg rype. _S�ngle Family _�upiez_Townhouse _Multi-Family _Commercial <br /> Type ot prcject New Adtlition Remodel Repair_T I. Sig�_Sprinkler Oemolition_Change of Use <br /> DESC RIPTION OF WORK(aedrt,onai spare prov�ded on tne eace� <br /> (�'�mOVL 4nQ. QtP �/�« �XiS '6���f_ f�001'���^� <br /> r� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pmjecl: _New_Addn _Alleralion_Repair Type ol PwjecC _New_Addn _�lieralion_Repair <br /> ShowNumber/q)oIliifures ShowNumber(HJ ollixtores <br /> AIC—air hand6ng units Toile� <br /> Fcrced air systems Bathlub <br /> Gas piping Lavatory(wash basin) <br /> waler heater � Shower <br /> Gas fireplace Kilchen sink 8 tl�sposal <br /> 6asrangc Dishwashcr <br /> Clolhes dryer Cloihes washer <br /> Ranqe hood Waler healer <br /> Ezhausl fan Smk(servicelhar/mop/elc) <br /> Healpump BackOow preventer <br /> Und heater Urinal <br /> Hoiler Dnnking Fountain <br /> Refiigeration Floor dran <br /> Woodstovc Greasc trap <br /> Duct�ng Rouf drains <br /> Othcr Medical Gas <br /> SPRINKLER / SUPPRESSION SYS7EM Olher <br /> NumherofHeads Other <br /> 1 hereCyCeMy I�al l Aave IeaE and erBmineE t��,app:icaUon er,d know I�e same lo ba true and cOrr�cl All provis�ons ol laws an0 oid��nances goveming I�:s lype ol woAw,A be comG'�ea <br /> wnn whelhtr<peuGeE neren or no1 Tne grenl�nq W a pertnd Coes not Dresume Io grve autnonty to v�olale or cancel Ihe pmvi9on ol any mher slate or IDUI law reguWung eonstructwn <br /> Tnal I am aulnoozetl Gy Ihe o�nncr allhis pmperty Ic pedorm t0e wmk Ior which appliw6on is made anC I mmp'Y w'h me Sta'e Conl:actois Law 78 Y7 RCW end 796]OQA WAC. <br /> �...,..�,/�-- � /Z� /j `�Z <br /> wneNAWhodzed genj ignaturc Dale (Revised6i7072) <br />