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PERMIT APPLICATION <br /> BUILDINGIMECHANICA L/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www•everettw 3rg /Z <br /> ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> t��p-r� PROPERiYTA%N PERMITt v^ <br /> SITE ADDR 5: , 1 � � J � <br /> �/ cJL � <br /> ! lo!No._ (anach copy ol long legal description) <br /> LEGAL for�ew construclion: ShoA PlaVsubdivislon <br /> -� � ,� PhonelE-mai �rZS Z�Z� � �T� <br /> OWNER� u. q �L� <br /> ��Z�_ ,.� c+tyrs�ate�z�P�J � <br /> Address u <br /> ApPLICANT:_Owner OwnetsAgenl �COMractor _,ConlractorsAgenl _Tenan�(r.,o+iwo�aeeienero!m�samrtanr.eownenoaowoM�nmesPace� <br /> (�A � L&I Lic.# �n)17�i COE Bus. Uc.# <br /> CONTRACTOR �� RJ <br /> Z�1`S .(f�-'�iiJ� p SicZL, �uefLc-(f Wq�19ZJ - Phone/Em 142.5 �� - - ) <br /> Address� <br /> TENANT BUSINESS NAME CONTACT FOR PERMI �� <br /> PhonelE�mail �ZS��j�� ' J' � <br /> BUILDING PERMIT APPLICATION <br /> CONTRACT PRICE OF WORK �o ° <br /> HEAT SOURCE: <br /> Existing Use of Building — <br /> Gas Eledric_ Other_ <br /> Proposed Use of Building <br /> Building type: �Single Family _Duplex_Townhouse _Mulli•Family _Commercial <br /> T pe of pro'ect: �New _.Addition _Remodel Repair_T.I._Sign Sprinkier �emolition_Chan e of Use <br /> DESCRIPTION OF WORK(addi;iona�spaceprovidedon�heback): �� � ��ai <br /> (,`�-1(-\rJC�E OuT C�F C-� A� �u2/JFIL� t - . .. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ot Pro�oct: _New,_Addn _Alteralion_Ropair <br /> TypoolProJecl: �` Now_Addn _Alteratlon_Repalr ShowNumOer(p)o/lixtures <br /> Show Number(N)o!lisfurcs i Tail6t <br /> � A/C-airhandlingunits � Balhtub <br /> I Forced air systems <br /> � Gas piping I Lavatory(wash basin) <br /> Water healer I Shower <br /> Gas fireplace I Kitchen sink 8 disposal <br /> Gas range I Dishwasher <br /> Clothes dryer I Clothes washer <br /> Range hood � Water heater <br /> Exhaust fan I Sink(service/bar/mop/elc.) <br /> � Hcat pump I Backflow preventer <br /> U�it heater I Urinal <br /> � B�iler I Drinkin Fountain <br /> � Refrigeration i Floor drain <br /> Woodstove , Grease trap <br /> � Ducting I Roof drains <br /> Olher � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I O�her. <br /> NumberotHeads � Other. <br /> I here6y certdy that I have reatl and exemined Ihis applicalion and know the sama lo ba Wa end wrtecl.All provisions ol laws and ordinances goveming lhis type ol xrorkwiA be complietl <br /> w11�whetner specifeC nerein or nol.Tho granting ol a Dermit tloee nof prasuma lo gh��,ro^'�made end I comply wn�t�e State Contredare Lew 1927 RCV�'d nd�%200A WAC.��ion <br /> Thet I Whorized by Iha v+mer ol lhla Droperty b pedortn t�a woIX lor whlch app' <br /> -' ' � � �-� ' �'� ( v (Revised o/t0121 <br /> OwnorlAu horizod A9 LSlnnaturo Dalo <br />