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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320D Cedar St., Everett,WA 982D1 425-257-8810 FAX 425-257-8857 �w�w.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: r�qv��a�y Taxa PERldli# <br /> 3121 Lvl-D AU6 W`fS 1�025�qOt> 7 <br /> LEGAL 1or rrewconsruclion: Shod PlaUsubdivision l.ct tto._ (attach wpy ol lorg lepal dexripti�m) <br /> OWNER lY��� D���i PhonclE-mad��'Z5� '7.5�- 215� <br /> 2413 "��Ils�OE �r1 ciry�statcrz�p EV��'�� WA q820,� <br /> nddress , <br /> APPLICANT:_Ov:ncr Omner'sAg^_�i �Conlracbr CenlraelorsA3enl _Tenant��,�:�nm�ae.me�,�o�w�namr.amvxo..ar+oao..wmme+coul <br /> CONTRACTOR GUCRG�rw'� $Tq;E•S��T M��— L 8 I Lic.S EVEQ����2oT COE 6us.Lic.# 00 <br /> nddress 'ZIZD Q{1C.1�«- �L•EVE (.7q 9a201 �hone,'emai� �{Zj �•sZ -31/�/ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> C42,�ZsZ-3U4 � <br /> �'(�'(.�OI�`{ �PVIGJ �-fK.� �'�� PhonelE-mail MAr�L S$��4•C�"t <br /> BUILDING PERMIT APPLICATION COIJTRACT PRICE OF WORK_ <br /> Existing Use of t3uilding ���''�''4�'' ��U HEATSOURCE: <br /> ProposedUseo(6uilding �µK��FF''� Gas Elecuic o�h=r <br /> Buildingtype: _SingleFamily _Dupiex_Townhouse _Mulli-Family ,�Commercial <br /> T e of pro'ect New Addition Remodel Re air T.I. Si n 5 rinkier Gamolilion Chan e of Use <br /> DESCRIPTIONOFWORK(additionalspacep:ovidedonfheback : p� S�St�"'� <br /> (L�t�no� ST�NG Dl� r�n5 Gv�c+osd, l�t�placn W( �-cmN �'c YvnQ . <br /> / '^ , o ew Gl.a:! <br /> vSCs CsA'�� ;koa;- Naw uvtc s HEnrs A��+Q wc44, t � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProjecL• _New_AAJn _Alteratlon_ Repair TypoofProJecL• _New_Addn _Alteratlon_Repair <br /> Shmv Number(d)ol/ixlares Sliow NumGcr(#)o/lixfures <br /> � FVC—airhandlinqunits Toile[ <br /> Forced air s stems Dathtub <br /> Gas piping Lavalo (wash basin <br /> Waler healer Showcr <br /> Gas fireplace Kilchen sink 8 dispo5al <br /> Gas ran e _ DisLwasher <br /> Clothes d er Clolhes tvasher <br /> � Rango hood Water heafer <br /> L=zhaust(an Sink(serv�se,barlmo /elc. <br /> Heal pump f3ackflow revenfer <br /> Unit heafer Urinal <br /> Doiier Drinkin Fountain <br /> Refriyeration Floor drain <br /> Woodsfovo Grease ira <br /> Uucting Root dreins <br /> Othcr Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Oiher: <br /> Number of Heads Olher: <br /> I herchy cr�ily rtia�1 have read and e+ami�ie�Ihis appi:calbn end tnow I�o same�0 6a Wo and coneG.M WM'�sbna ol Wwa and ortlinances Boveming Ihis type ol vroik viill be cnmplird <br /> �;��u��shcther specifetl herein or nul.Tlio 9��nting of a permil does not Frcwmo lo BWo authonly lo vblato or faneel No pravision oI any oNer atato or bcal lav�reBuWlin9 e�nsl�:dion <br /> ihal I nm aulliodmd 6y Iha mvnet ol llils pmporty lo padorm Na vro�k Wr whkh appLcatbn is mado and I�mply v::lh Iho Slala Conlradoro Lew 1827 RCl'J and 2BB200A INAC. <br /> � ��� �l�l� �°�d � <br /> Owner/Ai,lhoriz entSignalurc <br /> D.�to (Rovised G�'012) <br />