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,/ • • • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.evereriwa.org <br /> �/ w APPLICATIONS ARE ACCEPTEO FROM 8 AM TO�PM <br /> SITE DRESS: PMOPERiY TAX N P �T <br /> p sv�rE io3 ���it w� oo a° co oa � - <br /> LEGAL fw new conslruction: Shon PlaVsubdivisbn Lot No.= (atlach coPy ol bng lepal descnD�ion) <br /> OWNER 6� �ND�� -''3 GA'��1� Pn��-�a�� ,�U(o • 53$� o0B3 <br /> Address ��j ���uG ��vG U�"�T ��7• CirylSlale2ip 5�� ���N- 98/ua <br /> APPLICANT: Owner Owne/sAgenl _Canhanor Contrada'sAgen� Tenant(m�po�*aaxnno�mmmixamneo.�e�aao.wnu�swn) <br /> CONTRACTOR � 1 L 8 I Lic.# — COE Bus.Lic.# � <br /> Address '� PhonelEmail � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> jN�l GC•U�"�5 •- F1L�itf�1T � Nv r�� <br /> �L -r� Pxx�m Phone/E-maA 4Z� f)Z7• 2loU f 60.UEN�'_'C���+%N' "�� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK s veo <br /> Epsting Use of Building �1..'S'�{`��� � HEAT SOURCE: <br /> . . Proposed Use of Building .����� � Gas� Eletlric_ Olher_ <br /> � Building type: _Single Family _Duplex_Townhouse Mulli•Family L Cammercial � <br /> T pe ol pr �ect: New Addition Remode! ReDair T.1. Si n Sprinkler Demolilion Chan e of Use <br /> DESCRIPTIONOFWORK'addi�iona�spaceproddedonthn�scp: ���� 'C �`vM��� ��ITJUj`�J�'(i <br /> 11Jl�'2i�R �r P�ioro ( �oe �) 7a EX t1n� A�Tm <br /> p�N�NG SPf►aE�• <br /> MECHANICAL PERMIT APPLICAT101�1 PLUMBING PERMIT APPIICATION <br /> Typa ol ProJecl: _Ncw_Aedn _Alteration_Repair 1yAe o�Project: _New_Addn _Allention_Repair <br /> Shaw NumDer(t)o/�rfures Show Number(N)o/(Yfums <br /> AIC–air handlin units Toilel <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash basin <br /> Waler hea�er Shower <br /> Gas fireplace Kilchen sink E dispasal <br /> Gas ran e Dishwasher <br /> Clolhes A er Clolhes washer _ <br /> Ran e hood Water heater <br /> Exhaust lan Sink servicelbarlm letc. <br /> Heat pump Backllow revenler <br /> Unit healer Urinal <br /> Boiler Drinkin Fountain <br /> Retn eration Floor drain <br /> Woodstove Grease Ira <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINiCLER 1 SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> ��ere0y certily Nal I�ave read and eaaminetl Ihis aOV��'^antl know Itre sama to 6e W e and cortect.AA provsions ol hws antl oNnancea gwemv+g Nis typa ol work w+ll be cpnpfed <br /> � withwhetherspecdRdhere�nornol.Theg�anfogolapermidoes�rocpesumelogiveauMorilylavidaleorwnalNepravisbnalanyottieratateorbcalWwreg�iWlingmnsWtlim <br /> That I am aul�arixeE Oy Ne owner ol l�is properry lo perldm Ne worM�d which appliutbn is made antl I camply wllh Ne SUIe Contraclars Law 18.27 RCW and 2%.20DA WAC. <br /> , '� , �'-�►N�1(r Nfl t1�r�.cftt� µ/a���o,y- <br /> ner/Aulhori:ed Agenl 5ignawre Date . (Revised 6/'tC12) � <br /> � 2 <br />