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�ERMIT APPLICATIC� <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY GF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> G -��-�� <br /> SITE ADDRESS: PROPERN TAX q PERMIT# <br /> 34( -Z� U - 0 <br /> LEGAL lor new construclion: Shotl PlaVsubdivision Lot No._ (atlach copy ol lang legal descrip6on) <br /> OWNER � [.:��Q PhanelE-mail ���� J�Z�- ,J�[.�J� <br /> nda«55 3Cj( �—�2/iJ,¢ (/� CitylStatc2ip �/C��I7 �if/% "� <br /> APPUCANT: Owner OwnefsAgenl �Conlractor _Contraclor'sAgent TBndOl�muslprev�aoalocnclronsmibominao�nnerbCoworklnmespac!) <br /> _ , <br /> CONTRACTOR(� '> !�� (�� � , L� State Lia # w' n� Cdy 6us. Lic. # 00 <br /> nddress '(��� C>/}ea.� L ' Phone/Email ��{-ZS� ZCZ- 3�IY' <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> K�� Sa� <br /> PhonelE-mail L{ - // <e�� C�.eS.Sr»Cv�. v r <br /> BUILDINGPERMITAPPLICATION CONTRACTPRICEOFWORK�.3CL7.� <br /> Existing Use of�uilding __ HEAT SOURCE: <br /> Proposed Use of Buildmg Gas� Eiectric_ Other_ <br /> Building Iype: �Single Family ,_Dupiex_Townhouse _Mulli-Family _Commercial <br /> Type of pro�ect. New Addihon _Remodel __ Repair _T.I. _Sign_Sprinkter__Demolition_Chan9e of Use <br /> DESCRIPTION OF WORK(add�rionai space p�ovided on fhe bacrr): <br /> C�nt��(�L� �-{-i �in-1.S �-uc7n�4C� W( Qi S`�o I-..t/1r�fGt� <br /> MEC0IANICAL F'ERM14 APPLICATIaN 6'LllMBItdG PERMIT 11PP�lCATION <br /> 7ype ol Project: _New_Addn _Allera�ion_ftepair Type ol Project: _New_Atldn _ANeralion_Repair <br /> Sfmw Num6cr(a)o(lixfures Show Nomber(HJ o/lixfures <br /> � AIC-air handhng umts Toile� <br /> Forced air syslems � DaUilub <br /> � Gas pipin9 Lavatory(wash basm) <br /> � Waten c�ater � Shovicr <br /> � Gas lireplace � Kdchen sink 8 disposal <br /> � Gasrange I Dishwasher <br /> � Clothes dryer � Ciothes washer <br /> � Ranqe hood � Waten c�aler <br /> �—�� Exhaus!fan Sink(service/badmopletc) <br /> Hcat pump � Uar,kflow prevenler <br /> Unit healcr Unnal <br /> � E3oiler � Drinking Fountain <br /> � Refrigeration � Floor drain <br /> �__L Woodstovc Greasc irap ' <br /> � Duclin9 _ Roaf drams <br /> � Olhcr__--- Medlcal Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM O�hcr: <br /> � NumherolHeads _ Olher. <br /> I Im�eGy cetlJy Ihal I h�m icarl an7 eeam�ne�l I�r,.pp'¢a[on:mU bnow I�e same lo De I�va nnd co�mct.AC p�ovisions ol lixs nnJ ortl�nanee.gove�ping t�i5lype ol v+ork w?�De cnmpl�,t <br /> weh�.J�rO�er specdie��eic:n or nol Tne 9iamin9 ci n perm�l�or.nol pre:ume lo giva nuthon�y to v�ota'e or canccl Ine p�avi Aon ol any omer.la'e or bcal lavi re���laenq consuuc'.�on <br /> IM1.iI I aqi nvpmntc��y 1ne ovmer ol I�is proPeny lo petlorm�be wo�k Ior rduch aprliwbon u m:�le::nJ I�.en�,p;y�vAh tn,•$lale CcntinUor.l.:�1n'J HrV!anrl J'J,:ann V.41t: <br /> - ��`-'��---6 �z� " <br /> OwnedAulhurited Aycnt Signalurc Dal�. (l1e�o:�,l?/:pl!1 <br />