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PERMIT APPLICATION <br /> �UILDING/MECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERiYTAIf�/�/ZD y P RMI p - ,.,A! <br /> o a5 FvE-r «�� tva �✓nre_tl W'A Doyy;z (�lJtti <br /> LEGAL lor new consiruclion: Short PlaUsuhdivision Lot No._ (attach wpy ot long legal description) <br /> p J° ^' � <br /> OWNER �y (�j �(O P��teS LLL PnonelE-mail ( Zy 4•G�Ci 'y(rj/ r�ms. ac� ��cn�,rv�. <br /> earess a57�Z (�7G ��f• S W ciry�state/zip �-� h���u oco/ W,¢ �i 6G 3� <br /> APPLICANT:�Ovmer OwnersAgenl Coniraqor ConlraRotsAgenl T¢na�l�mmipmraeebr,ewlwnsemhommeownerbaor.onin�M�pam) <br /> CONTRACTOR I�uN��'uh Z"�c �/.Go�/ -O� �=n4 c7 <br /> L 6 I Lic.# dt 5 DOE Bus.Lic.# !Gt 9O <br /> [-!p �N( ll`[ .J f(n � ll'1 U�C � CJ�Ii <br /> ddress 75aS� �E- I`75�`' �LEnn�u�e 11/,4 J�GOZ� Phoae/Email �� z6 c - /v42 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Jn��� /hvtvS <br /> PhonGE-mad C����- Gs �L�J����"� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK r�, �3`�-`O <br /> Exisling Use of Building An�+�n.e.��S HEAT SGURCE�, <br /> Proposed Use of Building ���«�+��'� �a�io� Gas_ EieC�ic_ Otner_ <br /> Building rype: _Single Family xDuplex_Townhocse __Multi-Family _Commercia! <br /> Type oF pw eck New Addilion Remodel Repair_T.I. Si n S rinkler �Demolition Change of Use <br /> DESCRIPTION OF WORK(add�iiona�space provided on me eack�: <br /> 'fe�/ c�oW�� dwo u��� c{ c�cirf.,����(r . (6�6 � '�f��<.re�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATtON <br /> Type ol ProjcU: _Now_Adtln _Alteration_Repair Typo of Projecl: _New_Addn _Alteration_Repair <br /> Shaw Num6er(N)o!fixtu�es Show Number(M)o/lixtuies <br /> A/C—air handlin unils Toilet <br /> Forced air s stems Balhtub <br /> Gas piDing lavato (wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 disposul <br /> Gas ran e Dishwasher <br /> CloMes dryer Clothes washer <br /> Range huod Water heater <br /> Exhaust lan Sink (sernce/badmop/etc.) <br /> Heal pump BackOow preventer <br /> Unit healer Unnal <br /> Boiier Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Dudin Roof drains <br /> Other Mediwl Ga� <br /> SPRINKLER / SUPPRESSION SYSTEM olner: <br /> N�mber of Heads Olher: <br /> I�e2by cetlM�hnl l�ave reod enE ewmine0l�ie appGco�on nnC know Ihe enme lo be true nnd cortecl.NI pmvisioro al laws on0 ardinmces goveminy Il�is lypu nl wo�k wJ16e comptied <br /> wil�wtmiher syec�ieE�acin o�nol The gmn6ng ol o permd doca nal presume lo prve authonty lo vioble ar wnccl Vm p�ovisan ol any olher etote or bwl Ww repula4np conSWcuon <br /> �1I nm aul�omed�y I�e avmer ol Uie propeM lo peRortn I�c work lar anic�aDD6eilpn ii ma0c onOl wmpl/v.it�Ne Slalc Conlmtlon Lnw 1617 RCW nnU 25G.100�WAC. <br /> Ow rlAulhorized u nt Signaluro �D Date (Revisetl fi2072) <br /> � / <br /> C <br />