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PERMI'f APPLICATION <br /> BUILDING/MECHANICAL/PLLIMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVI=RETT PERMIT SERVICES <br /> 3?00 Cedar St., Everett, WA 98201 4?5-257-8810 FAX 425-257-6857 wvwv.everettwa.org <br /> APPLICATIONS AItE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: VqOPEHTYTAX77 P MIT <br /> `�r��l� �:'�/r!�is��//„�/ fi7/r? V dfi >v%�JG.voo.r-Gacd r�`o8- a <br /> LEGAL tor new CAnSUuction Short PIaUSubdrvision Lot No_ (aliach[apy ol long legal description) <br /> OWNER �/�%('�.7/,f7�" ��p ��%i;=_y' �i�i Phone/E�mad <br /> AatlreSS ��� �f lL9( � � �:/�i /�.%s� GD//SIatJZiP C1fGs's�G^/�i%ir�� ✓i�i.'` i�U � ,�Y�� <br /> APPUCANT:_Owner _Ov.ner'sAgent Conimclor i:o�Lacto(sAgenl _Tenantim�,�m.:c�+ce:ci��,��renom�+�o.-.�iaco.wn�:,u���sw<o <br /> _ — , <br /> CONTRACTOR {i s I L R I lic.# COE Bus. Lic.� <br /> Address Fhone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT v,g���c�//G Jr�:,;l/G�` <br /> V /� �� ��/�T'' �q� osd. '�'✓�Si 33i2 l.��tuvi'e:��:ry���- <br /> f'cj(i1T N ! PhoneiE-mal�,'�i'r�� r� �R;'�!,x�G-✓'�'.h2.eo . <br /> BUILDING PERMIT APPLICATION CONTRACTPRICEOF WORK �,J E•o�� <br /> Esistmg Use of Building �J w�//'!.�-��� �.e+��=t�= HEAT SOURCE�. <br /> ProposedUseofButlding ��✓i/i�ls��'� ���:�/�� Gas_ Eieanc Other <br /> Building type: _Smgle Family _Duplex_Townhcuse _Multi-Family _Commercial <br /> Type ol pro�ecY. New Addition Remodel Repair � TJ. Sign _Sprinkter_DemollUon Change ol Use <br /> DESCRIPTION OF WORK(addiGonal space provideAon�ne Dack): <br /> !�. % /?i�/'U �.;r'!!."•i i �.c�f= �?i-'��J.?i"9G.f';'i.��-�i:•"/'. <br /> MECHANICAL PERMIT APpLICATION PLUMBING PERMIT APPLICATION <br /> Type o(Projecl: _New_Addn _Alteration_Repair Type ol Prqecl: _New_Addn _Alleralion_Repair <br /> Show Num6er(pJ ol lixfures Show Number(y)o/finures <br /> A/C-air handling unds Toilel <br /> Forced air s slems �athtub <br /> Gas pipin Lavalory(wash basm) <br /> Waler heater Shower <br /> Gas fireplace Kilchen slnk &d�sposal <br /> Gas ran e Dishwasher <br /> Cbthes d er CloNes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(servicelbar/mo Ic tc) <br /> Heat pump BackOow preventer <br /> UnH healer Urinal <br /> Boder Drinkin fountam <br /> Refri eration Floor drain <br /> Wood:dove Grease irap <br /> Duclin Roof drains <br /> Other Med�cal Gas <br /> SPRINKLER I SUPPRESSION SYSTEf!� other: <br /> Number of Heads Other <br /> I�ere0y ceNfy i�al I hove rtatl an�e�amned��is app4wiron an�Ynow Ilie same lo�e Vue anU mne<I.NI pmvisians ol laws and ortl�nances goveming Uirs lype ol work w�il bo compl:eJ <br /> w�ih whM�cr sOcuEcO hemin or not.7�e granling ol n O��il tloes nnl pmsume l0 9rvc aulhonty lo valale ar eincel Ne piavivon ol any nlper slale or batl Liw rc9ulLing wnsimclian <br /> i�al l am auNonzcd by Oie ownei ol Ihis pmVeny�o Dehorm L�c woik lo�w1uUi aDG�icalqn is maae an01 ccmpty wiN Ihc Sialc Comacmrs Law IB.P RCW nnJ 296 200A WAL. <br /> l�.^�Y'eiL`/r/�����''' ✓ •�✓• �� <br /> O�vnedAuthorized Ayent Signalure Date (Hevisetl620721 <br /> �/ / <br />