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� � <br /> PCRMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 37.00 Cedar St., Everett, WA 98?_Oi 425-257-881U FAX 425-257-8857 �w,nv.evereltwa.org <br /> �,)2 —� U <br /> SITE ADDRESS: PRO�[Riv inx q �e aii• <br /> �6 o e . ��t.t� / c� A -00 <br /> LEGAL icr reu.:.n;tr�;��sn� Shod PiaVsu6division Lot P:o_ (atlaeh eapy ol lorg I�nai Uru¢Imn) <br /> OWNER �yol� LM�RR- PncnerC�mail .'lab. �l�-.��� KlN�.'lN��a2.� wr+^Q• <br /> �1du�ess "-I <) �-r ( � �Q. CJ . C--�- C�ty/SIa1cIZ�p �U2� / f.�A /S�-��4.. <br /> APPUCANT: � Owner ONncr'sAgent Conlraetor _Com�aUcr'sA,eN Tenanl�m�uyo.roeoieu��cnM.,�.,t;�omm,_.re�iae�w;.n,�nc:x.a.i <br /> CONTRACTOR State L�c # C�ty Bus Lic # <br /> i�aCress Phene/EmaA <br /> TENANT BUSINE55 NAME CONTACT FOR PERFAIT � <br /> colby �z �tar�- .�=b a�b.s-s-�� . i��.. '�' fMIA.�-�4�e_ � <br /> Phcnc�[ma� (l <br /> BUILDING PERMIT APPLICATION CONTRACTPRICE OFVJORK S�� �� 'S��N� <br /> Ex�sl�.ng Use of Owidmg_� � ' D HEAT SOURCF <br /> Proposed Use ol BuilCmg�"'f�hT�"4R1� 1�'e����' Gas__ Eieclric_ o�her_ <br /> 8uilding rype. Smgle Fam�ry _Duplex_Townnouse _Multi�Family �/ Commerc:ial <br /> Type ol pro�eW New Adtld�on Remodel Reoair 1�I _ S�pn _Sp�mkler_DemohLun ✓Chanq^ ol Use <br /> DESC RIPTION OF WORK�nem,r.�oynar spuce pmv�vea on n;c r.acal� <br /> �(�,s1Q,l�� 'Il�¢, SD�CIl *� /Nl�ll Ir'`PY� <br /> a <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project _No-x_AJdn _Altcralion__Repair iypc oi Projecl; _New_Addn _Atteralion_Rupair � <br /> Show NumAer/p)o/b+'fuirs Sha w Number(b)ol lirtures <br /> NC-air hanALng un�ts � Ta�let <br /> � Forced au systems � Balhlub <br /> � Gas piping I Lavatory(wash basin) <br /> � Water healer � Showcr <br /> I Gas fiieplace KAchen sink 8 tl�sposal <br /> � Gas rangc � Dishw35hCr <br />� � Clothes drycr Clolhes washer <br /> � Range hood � Water healer <br /> � [xhausl lan � S�nk(servicelt�admop/elc ) <br /> -� Heat pump � Backflow revenler <br /> � Und hcalcr � Urinal <br /> � �niler � Drinking Faunlain <br /> � Rclrigeiation � Floordrain <br /> � Woodslove Grease Irap <br /> � Duchng � Rooldrains <br /> � Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSYEM � Other <br /> I Number of Heads I Ofhec <br /> I nerc�y<en�ly Inai 1 have re¢i an0 evami�ed IPis aFG'����ron a nG 1 norv I�e sart'�^lo be hue anJ mrreU.All provisians o!laws antl ordlnances govrimng I�Is t�pe ol.rork xiil[e mmpsc.l <br /> �¢;h whelner spcufica Aernn or r.ol Thn,graneng ol a permJ coM nol prerime lo grve aulhonly lo vio'ate or<anRI11e prorismn ol anv otAer sta;c ol local law regulalirg contlfuUicn <br /> Tnat 1�m aul�orizetl�y me o-..ner ol l�is pmF�ny to FeAorm Ihe xork for�Mlch app�icahan u maJe an]1 complY x�nn the SIaiC Contracl0rs Law IE 17 RCW an0198 20.'1A WAC. l� <br /> z <br /> /LU^ �, Q— C�-I� <br /> OwnedAulhorized mitSignaturc Datc (Rerisey3?07�) <br />