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P�RMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINftLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257 8857 �^nrnv.evereitwa.org <br /> SITEADDRESS: PROPERTYTAXq PE ITN` �/_ <br /> . I1�� Eu�S (re� NL � � ' � E� <br /> LEGAL(or new conslruction: Short PlaUsu6division lol No._ (atlach copy of lang legal descriptian) <br /> OWNER PhanelE�mail <br /> Atltlress Cdy151aIc/Zip <br /> APPLICANT: Ovmer _Owner'sAgent __Conlracror Conlraclor'sA9ent _(enant�c„siprcnma�c-erc�c�-.,.�m�mmi^.00.oe�roeo..cr.�n�no:Pe�o� <br /> CONTRACTOR ?l�P �f� S � Stale Lia# R�Ps(,��qZg M�►cily Bus.Lic.# <br /> �AdOress �p gQ7C I � {r!(111+ S PhonelEmail ��'�pp � v) ` <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 4,�, ���'Z`q�' <br /> ��• lNl,� i4yh �,/Q.Jley P�r • PhonelE-mail e� � �Ufn,j ( ���Yh <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ��.5 OO _ <br /> Ex�sting Use o(6uitdirg .5 C�� 3�0 / _ HEAT SOURCE: <br /> FroUosed Use of Building � 1 DT �«- Gas._. EleUiic _ Other __ <br /> 6u4diny D�pe _Siryle Family _ DupW_a__Tavnhcuse _�:4�IIi�Fzm�ly _Commercial <br /> Type o(pro�e[t Ne•.v ACAiiion _Remed-el L Repa:r�T i Sign XSpnnkier Uemoldion_Chan,e ol Use <br /> DESCRIPTIONOFWORK;add.hcnal=paceF�u•�idedonihet•ar.k� � <br /> Re.�oCYJ�2 20 $�t, n�.IPf �o M��� �� e � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projecl: ,_New_Addn _Alteration_Repair Typo of Projecl: _New_Addn _Allera�ian_Repair <br /> Sim�v Numbcr(ttJ ol/lxfuics Sbow Numbe�(A10(/ixNres <br /> NC—airhandlin9units I Toiiet <br /> I Porced air syslems I Balhtub <br /> � Gas piping Lavatory(wash 6asin) <br /> Water heater I Shower <br /> Gas freplace I Kitchen sink 8 disposal <br /> � Gas ranGe I Dishwasher <br /> I Ciuthes dryer � Clolhes washcr <br /> � Rangehood � Waterhealer <br /> � Exhausl fan I Sink(service/barlmop/etc.) <br /> � Heal pump � Dackllow preventer <br /> � Unit heater � Urinal <br /> � E3oiler Drinking Faunlain <br /> � Re(rigera�ion Floor drain <br /> Woods�ove � Grease Irap � <br /> Ducting � Roof drains <br /> � Other_ � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Other <br /> �f� Num6er o(Heads � Other: <br /> I hereEy cerlily Ihal I have reai and eiamined Ihis appli<ation and AnewiGe same to te We nnd mned.All pwvisions ol la.vs and crecances goveming Ihis type al woh w.li be complicd <br /> µvh whei�er spec�feU herein cr not.i�e 9ranling ol a pertnil tloes not presume lo give au;�onty to Wo'a'e ar canccl Ne pmvision a1 any a�e�sla�:cr Iecal law regulaliig conslmc�ion <br /> That i am autho�ixed by��e oxner el��is wpe�y lo petlor Ihe uork Ier HTich aDP'�caiion is maAe an�I mmply w�i�ihe Slate Con�racinc Ww 1B 21 FCW xnd 296 200A 1YAC. <br /> �e�l/ iYy 7�25/ iy _ ___._. <br />