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� <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERElT PERMIT SERVICES <br /> 32G0 _edar St., Everett, WA 98201 -425-257-8810-FAX 425257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM <br /> SITE ADDRESS: PROVERiv 7AX� �E MIT M <br /> ,�slc� rCca Rvc � � s,�7�s� �a.� 700 <br /> LEGAL fo'newwnslmr'.ron� Sho�PlaUnubOmcon lot No._ (at1aU�mDY�'long IeqalOescnpLo�) <br /> OWNER �Jr7f2u {Z/R7✓ Pnanc/E�mau y�s- .j}U— �'/S � <br /> naaress l,� C E c.ryisuwzro - l9 ��d'��l <br /> CONTRACTOR L �7 AIE' '1 6��'�.k <br /> are��fv�0 G !J �I�C ,J6. n.� g 3 Phorre/Emad �3F.o '757'0933 re`�4 •"st <br /> TENANT BUSINESS NAME CONTAC7 FOR PERMIT <br /> PhonrlE-mail <br /> BUILDING PERMIT APPLICATION LONTRACT PRICE OF WORK �l��000'- <br /> Fx�sUng Usc o1 Building HEAT SOURCE: <br /> Proposed Use o(Building �s ��+�_ a�e' <br /> Bullding rype: _Singk Famity _Dupiez_7ownhouse _Mutti-Family �Commercial <br /> Typeoiprojed: _New _Adddion _Remodel _Repair_T.I._Sipn_Sprinkter_Demoldion_Change ofUse <br /> ' Desai (i0n ot Work(a00rt�anel spar»pmvded on fhe back): <br /> ��� re�r.:r �t rc�l¢ee I y" <br /> U�'(L� I<<^I: L�C4ri �# CuG'FW/0.IK.t+rLtLL�s� C�LI�hc,,. µ1�Yr" v'���- !'f���G�i 2K1({i�,�. -ro Y�yw���.�a,�N,sh��l <br /> � NCw PvC. <br /> • HaveyounWrtedworkingwitboutapermit9 _YES �NO ��C�n�..-�Gu�ci plywr..q <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type o1 Vrqect: _New_Aadn _�Iterotion_Repeir Type d Project: _New_AdCn _AllenUon_Repair <br /> SAow Number(YJ o/Ailures Show Number(N)ol frrfume <br /> A/C-air hantllin un35 Todet <br />' Forced air s Stems Oalhtub <br /> Gas ipina ' Lavato wash basin) <br /> Water heate� ' Showei <br /> Gas fire lace I Kitcnen sink 8 dis0osal <br /> Gas ran e � Dishwasher <br /> Clothes d er C�olhes washe� <br /> Ra�ge hood J_ Wate��eater <br /> Exhaust lan &nk�serv�celbar/mo /etc <br /> Heat ump Backllow revenler <br /> Unit heaiei Urmai <br /> Botlei Ormkng i ountain <br /> Refn erahon Fioorarain <br /> WooAstove Grease Irap <br /> Duqing Root Erains <br /> OIAer Meairal Gas <br /> SPRINKLER /SUPPRESSION SYSTEM other <br /> � NumberofHeatls Olhe� <br /> I nemby cert�fy Ihat I he�e read end e�amined Inis epphratron ar.0 know Ue same to be true en0 corted.NI pmns�ocs ol laws enC ordinances goveming <br /> this rype ot�wrk vnll be mmpiie�vrilh whether speclfied hemin or not.The g�aahng ot a permd dces not presume to A��e aulhonty lo hoWte rn anwl <br /> Ihe pmneion ot a.ry olhe:atate o�looil lew repulatmg conslruclion or Iha perbnnanoe M cor;Wdion.That I em euthonmL Dy Ihe rnmer ol this pmpa.ry <br /> to pedo'++�Ih rk b�wfiK �p!i �is mede BnE I oomply w9h Ue SUte ConlraRors Law 1817 RCW enC 296 100 WAC �1 p�-7 G� <br /> "��' � K v� c��e,ue �(/l rl�� <br /> Own rAulhotlzedAgem5lBnature Date (Rensetl7/1071) <br />