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PERMIT APRLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERI�EMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wv✓�v evere3va.or�, � <br /> SITE ADDRtSS: , Q Q PROVERTV TA7f p PERMIT p - <br /> L L �.�L <br /> L[GAL lor new constr�ction�. Shoil PiaUsubdivi;ion Lol No_ (altach copV ollong Icgal Acscripl�en) <br /> OWNER L' V'el�� h N�LIU /!� honeiE�maii C.� S-.�3-1lz� �JI"'C�/�iC1�Qi7�7�r t'u�7G. )/� <br /> ndOress 7 v h( �'C�/7�.�'� Ciry/Sla�elT_ip � vc�� N ee�� 9P�v <br /> APPLICANT:_�Owner _OwneYsAgent ContiaUor ConlractofsAgenl Tenanll^�+�o�c��aooien��acoosm�.nommov,����iaeo«o+m�nnso����l <br /> CONTRACTOR Stale Lic.# Clty[�us. Lic ft <br /> AUd�ess PhonciFinail <br /> TENANT 6USINESS NAME CONTACT FOR PERMIT jYe I'�C�Qj���•VI�T��OIC�/ <br /> PhonN[-inan L�.i7.7��U 3-��Z l J <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �/�7.OQO <br /> f_xisting Use o1 Buildmg 11� �1(h H[AT SOURC[. <br /> Proposed Us?of Oudding._ �/�i�1'7� Ga,__ Eiec�nc_ Oihcr__ <br /> Bwlding type�. _Singlc Family _Duplex_Townhouse Multi-Family � Commercial <br /> Type of projecl. tJew Adddion _Remodel __ Repair T.I. Si n Sprinkler_Demoldion_Change ol Use <br /> DESCRIPTION OF WORK(ane�oonar space provided on the back/: <br /> ` - — �scvdda�� l�r.�'w.f� <br /> /}C�L�/r 11C�'��-�'a�C�'IE:�-/ 7— <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> typA of Projca: _New_Addn _Altcralion_Repair Typo ol P�ojeeC _New_Addn _Ntcratlon_Repair <br /> Shaw Numbcr(q)o(lisfares Show Number(q)o!lixfuies <br /> NC-air handling units I 7oilet <br /> � Porced air s stems � Balhlub <br /> � G�s pipinq Lavato lwash basin) <br /> Waten c�ater ����di1=r <br /> Gas fireplace I Kdchen sink 8 disposal <br /> � Gas range Uich�vasher <br /> Clothes drycr (:lolhes v+asher <br /> Rangc hood I WaLn c�alcr <br /> [xhaust fan I Sink Is^-rvicc/badmop/etc) <br /> Hent puinp I l3ackllow preventer <br /> i Urut heater Unnal <br /> � Bnilcr ! DrinYing Fountam <br /> � ftefiigeralion � F locr drain <br /> Woodslove Grcase Irap � <br /> D�chn7 ' Roof drams <br /> Other � Med�r.31 Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other <br /> Number of Hratls Other <br /> 1 p�. .:�y i..rLly Ipi�l I hqru�oaJ on�c.anuncd 1hm applen;mn a��d V noH liir.:ame to�e Lac anJ tnrtn[I All pmnvons nl laws.nd oi9innnces gocemnp IM±IYCa ol wniY w,Y be u�mPL�,I <br /> nr4 xhcl�ei spcv.PreO�ciem or nol The qrantn3 0l a DcrmA tlocs nol pmsumc lo y�vc auR�o�'�Iy io�iu'�:�c ur canr,cl'�v pim�is�on ui a��.Y ni�er>laic or��Gil law�epui�nny cnnstnirvm�� <br /> �!,a�I ar�,a�ihnrileE by IAe owne�of Ihn prope In pedom�ttic woiA fot which apphcaSon�•,maoc au�I wmpiy wiR�Ric L"atc C�Yihm�ms Ww itl 27 KGVJanJ 2"6'004 V:%d; � � <br /> ��_/,�����i�G : � /� <br /> , /� �.��,� <br /> Owned�u�horizod Agonl Signnlure f)nt� p:c¢��.,,1 ��0�?) <br />