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From: ! 0717F�2012 11 :02 #736 P.0031003 <br /> � l <br /> PERMIT APPLICATION r��a�,ft0 <br /> B UILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-885� www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM .— � y <br /> SITE ADDRESS: � PROPERiV Tl1%M P T <br /> U04sCl�Gax-�v� <br /> LEGAL lor n¢w co�atnictlon� ShoA PlaVsuDGivitlon LIX No._ (etlach copy of lonp lepel tlexrlpllon) <br /> OWNER 0. lff� PhonNEmail �`:J " l� O✓L-L <br /> AOdresa � � 1 � �/ CIryl5latNZlp � —1 �� <br /> APPUCANT:_Oo*�er _Ovrtiar'sApent +�ConlraUor _CmlrecloteApent _Tenanll�v�w.rn.roioonwm�omn.a.+r.aae.omm�.�o.u� <br />, CONTRACTOR r ( L 8 I Lk.M� S�W � F�G COE Bus.Lic. 3 <br /> Addrose '2�0�1 �32 `� N a� V�11"� O�� PhondEme (nl ��1 V1Q�1��� � Y� <br /> TENANT 8 S N CON ACT FOR PERMIT ��� ��1 ' <br /> u2�7 ��-� <br /> � PhonNE+nsi � •�-�� <br /> BUILDING PERMIT APPLICATION CONTr+nCT PRICe oF WORK <br /> Exlsting Use of Building HEAT SOURCE: <br /> Proposed Use olr,B/uilding _ Gas_ Ekcmc otner <br /> Buliding lype: '"�Singie Famlly _Duplez_Townhouse _Multi•Famlly _Commercial <br /> T ot ro'ect: New Addition Remotlel Re elr T.I. SI n S rinkler DemolNion Chan e of Use <br /> DESC RIPTION OF WORK(eadirlono�apece prov�ded on tAe back): <br /> 6�X��vC_ �- re�p�ace. 1�f-C-4'�iG 1.1�0��'-fS hQ('.l-'rf� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLIGATION <br /> Typa ol ProJecl: ,_New_Adtln _Altaratlon_A�p+lr 7yp�o/ProJ�cl: _Naw_Addn Altanlion_R��palr <br /> Show NumDer(I o/Ilrtuns Shaw NumDer N ol Axturca <br /> qIC—airhandlin unils ' Toilel <br /> Forced air s stems Balhlub <br /> Ges i In Levalo wesh basin <br /> � Waler healer Shower <br /> Gae fire lace KRchan aink 3 dis sel <br /> Gas ren e Dishwasher <br /> Clolhes d er Clothes washer <br /> Ra e hood Waler heatnr <br /> Exhaust(an I Sink servicelbarlmo lelc.) <br /> i Heal ump Backflow prevenler <br /> Unit�eater Urinal <br /> � Ooiler Drinkin Fountafn <br /> • Rehi erallon Floor drain <br /> Wootlstove Greace Ve <br /> Oudin Rool dralns <br /> Olher Mediwl Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heatls ' Olher. <br /> ��ereby emNy Ihel I hrvs rentl�ntl�nmN�C Nb�ppk�lion enE lnow 1����me lo Oe Wo�nC cortect.Pll pmWabm ol kw�entl orCin�nena poveminp I�u rype ol woA wi oe rompME <br /> wN�whel�x roecifio0 hanin or nol.TAe pnmhp of e partnil tloo nol pnsume lo plve�uMaMy lo vb4te a uncel Ne prwi�im ol�ny oNa M�te or bul Nw�apWetNp coni Wc�ion <br /> TT�I I�m�uNotlx�d Uy N�ownor IN 104 p�opMy lo potlam IM v.pM fo�wfik0�DDk��p��m�Os�nC I comDN��Me Sl�le ConU�clan L�w 18.77 NGW�n0 296.700A WPC. <br /> ��ZLn 1Z <br /> I utnoricod ABant§Ign�hre Date (Revised 620f2J <br />