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PERMIT a►PPLICATION <br /> BUILDINGlMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CI'Y OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98207 425-257-8810 FAX 425-257-8857 www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPEHiY TAX 1 PEgYIR <br /> a4 I -!a, �!� aYoszo�o �,tov9oo ,� <br /> IEGAL for new oonstruction: Snort PIa1lsuDdrvision Lot No._ (attach mpy of bng legal description) <br /> OWNER�QLIf BtaS. �mes Ph�.�,�qts zyo z a9 'oelehu4cklroH��dM <br /> naaBss z t 8 l'� � tiE ccr�s�ai�v � sv i (le C� � 9 t 7a <br /> APPLICANT: O�mer Ovrt�ersAgent �Contractor ContraUofsAgent Tenanl�m,m,yo,aoaiecram+�cmmmmoa�.wroaawnne�ezuml <br /> CONTRACTOR Q�lt� ��'0 S. �+oMPI L 8 I Lit,ff GC<< Q'Iv{L Z COE Bus.Lic.N <br /> Addmss39LZ 8��-'' A� � �r SU1� QQZ�O phonPJEmail �(�'��QQ(k�fpTlp/T (t\�^1 <br /> TENANT BU I NAME CONTACT FOR PERMIT <br /> 5uel N c�4c� '��-Z4v-24 29 <br /> PMnelE-mail <br /> BUILDING PERMIT APPLICATION CONTRaCT PrtICE OF WOrtK <br /> Epsting Use of Building S� HEAT SOURCE: <br /> Proposed Use of Building Gas Eieanc_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commerdal <br /> T e of ro'ect: New AddiGon Remodel Re air T.I. Si n S rinkler Demolition Chan e ot Use <br /> DESCRIPTION OF WORK(addeiona��oace providee on tne Dacx): <br /> dJE�f�C11��'cV1 ex IS-�iYl9 S f 1` <br /> MECNANICAL PERMIT APPLICATION PLUMBIN�i PERMIT APPLICATION <br /> TypeotPro�ect: _New_Addn _Alteratfon_Repair TypeolProject: _New_AAdn _Alleration_Repeir <br /> SAow Number tl)o/fixtures Shaw Number MJ ol f+xturef <br /> ; AIC—airhandlingunits � Toilet <br /> i Forced air s stems i Bathtub <br /> Gas pi �n ; Lavalo wash basin <br /> Water heater � Shower <br /> Gas fire lace Kitchen sink 8 dis I <br /> Gas ren e ; Dishwasher <br /> I CloMesd er I Clolheswasher <br /> I Ran e hood � Water heater <br /> I Exhaust fan I Sink servicPJbar/mo letc.) <br /> � Heat um I BackBow reventer <br /> I Unit heater � Urinal <br /> I Bailer � Drinkin Fountain <br /> I Retri eraUon I Floordrain <br /> I Woodslove I Grease lra <br /> I Duttin I Roof dreins <br /> � Other � Mediwl Gas <br /> SPRINKLER/SUPPRESSION SYSTEM � Other. <br /> � Number of Heads � Other: <br /> 1 hereGy ceiWy tl�at I�ave 2aU an0 e+amineC Nis appf�Gon anO Imow Ne same ro Ee W e anA mrtetl.AO provivons al Faws and artlinnnas goreming Uis rype ol work w110e mmp5ed <br /> xiN whcl�er spedfieE Aere�n or nol.7he g2ning ol a perm�Caes nal Dmwme ta give aut�oNy lo viot�te w onal Mc O�v Won ol any oNn stalc or lo�l law regulatv�p consLutlion <br /> TAaI l euNoraeE Cy c wmcrol Nis O�O�M 7erlo�m tlie woM PorwLiN aOG���maEcanC I tompry wil�Ne Sire Contradors 1:�+18.77 RCW onE 296.700q WAC. <br /> � 3�12-1 y <br /> O rlA 'zed Agent Signatu Oate (ReviseU fi20f2) <br />