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From 09109 '"�13 D9'4a �182 P 007/007 <br /> GS � �Z� � <br /> PERMIT RPPLICATION <br /> BUILDING/MECHANICALlPLUMBINGlSIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , Everett, VJA 9820i �25-257-8810 FNX 425 2S7 8857 rnNw evereltwa crg <br /> APPLICA710N5 ARE AGCCP7ED FROM 8 AM 10<P1d <br /> SITEADDRESS� _ vnOFjl TA M p �niry ID � <br /> � 3 <br /> ICGAL Ir.•ncw cpnslrucicn Spptl nlaVsvDC.viGion Lul No ;9VBch coOP o1�urg ICya�O��scnptun) <br /> OWN[H 7 vna�eiF�R.,�i ' <br /> v o � 1� '�' � � <br /> �,ave:s cn rsia�wn <br /> APPLICANTt Owner Ow.�nfs�qent �Wnl'a[tor ConYaroh,Ag�n� Te�ail,�.�U��rome�v.na<an�xr�a,ri+eo..�.n-.ev.oenn����:p <br /> CONTRACTOR �a� v�� F{��1' L d I L�c.k� ��j�Y`�YV 15�1 �L.���-COE Ru5 L�C k (, �-j� <br /> hm��cs � �IiY�S Nonn Creek'Pa�kwa South,S1EC-106 gOthell, VdA 98071 me,� mi� � r� —n.S�"I,JC� :C�1Pn-{e1,(i � <br /> IENANT BUSINESS NAM[ CONTACT FOR PEHMIi ��a����� �r ��1 � <br /> U2� �cr3.� <br /> Pne�vi�E�ma�i � � � � f �L <br /> BUILDING PERMIT APPLICATION CONiNACT PRICE OF WORK_�_� <br /> Eri;brg Use o!6m�Ong �� � ` HEAT c CE <br /> PrcOosM U5o G}dwitli�g_ Gas bcinc _ OI��'_ <br /> Buutlmg type� _Smgle family Uuplez Townhouse Mulli-Family _CommerGal <br /> 7 of pro cu New Atl temoEci _ qepart TJ Si n_Spnnkler Demoltlion Chan e ol Use <br /> DESCR�PTION OF WORK(e0aaonei cpeceO�o�iOcoon me tacp: <br /> ��-�'u4L 11 c' G� �o-�IQ.CQ- l�?QEC IY��C U�cS�'�" ��r.�x��' <br /> MECHANICAL PERMIT ApPLICATION PLUMBING PERMIT APPLICATION <br /> Type 0�ProJCU: _NCw_Atltln _AMBrallon__HCpnh Typc O��rafocL _ Now_�tlOn _411e�utlon_Repolr <br /> S�ow Numbw(/1 0l Ilnums S�ow Num.bor(Pr ol/Ir(mes <br /> FVC—eir hAntlhn um�s TMIei <br /> � Fo�ced air y slems BrUilu� <br /> ! Gas pi0ing i 1 avator (w050�ASin� <br /> ! 1'Jaterl�nalar <br /> Shovm� <br /> Gas ii�c lace � Keche�sinM 8 tliepo5at <br /> Gas ran 0 D�shwashe� <br /> Clo�hes tlr er Ciol^.c;washer <br /> Ran n hnod waicnc�ater <br /> Exh-��st fan Smk(;ervi[ePoar/mop/elc) <br /> Hea. ;um Oachllowprovenler <br /> Unit heater Unnal <br /> (3oJrr pnnk�n Fountam <br /> � Relr�ci�don Flo�r����in <br /> YJoo7srove G�ea,eda <br /> Dncbng Rooi dralns <br /> n��'e1-- MeCicai Gaa <br /> SPRINKLER / SUPPRESSION SYSTEM otnoc <br /> Nu�,bcr of Hoxds Olner <br /> i��e.aoy cen!�y Pa�I nern-e�d ena rmnnutl M4 epplce4on ene xnpw Te��mn�o oe iNa snd cpr��t N�.pmviebm ol�m�nG eNFY�cef qovemmp IRf lype ol rv�b6 b�mmpbe <br /> wm w*�Ibb�pacl�eC namm a�nu1.R�e pi�nLL�O al�Oarrrvt tlw�ne�emwme la C�e an�wtl�to value oi ancet IM1�perliun ol enY��e�aaie or bctl qw rppulrpnp:ontlruc�nn <br /> t6n�i�m eumomtU GY tb amm N Nn OnppM lu Detlwm 0�wort(o�wh�N pp{ra�qn b rruA<nna I wmph MN Ry$YIO Cm4/Cbrf 1 M te.71 PC W MW)9G?OM WhC. <br /> � � WwrizetlAgenlSignefur� �� (Rev�so06?OI7) <br />