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� � <br /> PERMIT APRLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 425-257-8810 FAX 425-257-8857 �wrw.everetiwa.org <br /> / �30�/' <br /> SITE ADDRESS: � _ �� PROPER7Y TNf p p �� � _ O�� <br /> LEGAL lar new wnstruction� Shotl PlaVsu6division Lot Mo._ (altac�copy of lon9 legal descriplion) <br /> OWNER l:.v� � N uv � Phone/E-maii yL�j- � - 3S0 (`�� �rWe� �� <br /> Address . , � �� -� Gty151aleRiP �j V ej���� W ��1 Q��aO <br /> APPUCANT:_ Owner Owner'sAgenl Canlraclor Contraclor'sAgenl Tenant��u,v�m.,eoaicne��iwnso�nm.,,m,o,r�rueo..onmm��n+rn� <br /> CONTRACTOR � <br /> � State Lic# GI Dus. Lic. # <br /> �ddress Phone/Ema�l <br /> TENANT BUSINESS N/1ME CONTACT FOR PERMIT <br /> S�� Phancl[-mail Sry�mTi <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK. �QQO <br /> Ex�sting Use ot t3�iiltl�nq fl ' YI���� Hl:AT SOURCE. <br /> I�f � <br /> PropOSBd USe Ot OUllding V(" C� Gas � Eleclnc Olher <br /> �wldmg type: _Single Family _Dup�ez_Townhouse _Multi-Family _Commercial <br /> Type ol pro�ect� _New _Addition _ Remodel Re air T.1. Si n_Sprmkier_Demolltion Ghange of Use <br /> DESCRIPTION OF WORK(adm�ionai space provmed on�no tack): <br /> L-tti�ci��r� o � i ��cfividUal o��ict� space,sl.�i �h �' -hall WaIIS <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol Pro�oct: _Now_/1dJn _Altatatlon_Ropalr Typo of Pro�ocl: ,_Now_Atltln _Allora(lon_Ropalr <br /> Show Number(p)ol llxfures Show Nambcr(tl)o/lirturcs <br /> NC--a�r handl�ng units � TotlM <br /> I°oiceJ air syslems Bathlub <br /> Gas pipm Lavalo� (wash basin) <br /> Water heater Shouer <br /> Gas Greplace Kdchen sink 8 disposal <br /> � Gas range Dishwashcr <br /> Glothes drycr Clothes washer <br /> Range hood � Waler healer <br /> Exhausl fan Smk Iservicelbar/mop/Me� <br /> Heal pum � g,ckllow preventcr <br /> Uml hca�cr � Urinal <br /> �otler I Drinking Pountain <br /> Refngcra�ion � Floordrain <br /> Woodstovc Grease Irap <br /> Ducling ' Roo(drains <br /> Other _ � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � p�her. <br /> Number of f ieaAs � Other. <br /> I hrmLy cei4fy Ihat 1 Auve icad unu e.anunc�l Ru::,yphoiLnn ontl lnox Ihe samo lo be Lvu nnd mrretl.All p�ov�5lona ollaws pnd ordn,mces goveminp I�iS typo ol woik vnli no compueq <br /> wit�wticl�cr¢p�c,imdpacinano� i�c9mNmgolaprrmAtlocsnoipresmnclogrvoaut�orilylovwlateorwncclt�eprov,ionofanrot�crs���too�bu�llnw�egu6iunpconsuuclinn <br /> lAa�I am amnomed Oy me ownrr cl tna p�openy peAo�m tAe woi!lor vmicn apph�vion ie maae ana I comply wnn I�c SIa1e Cormm�ors l,rv lU 7i RCW nna MG]noq Wnr <br /> t� 0 � i� � � ��L <br /> Ownar/ uthorimd Ag nl Sd�ro atc (l7evr,;c0 1:'Of7J <br />