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r � r ' <br /> PERMI� APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGN/S°RINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVII:ES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257•8857 ��rrnv everettwa org <br /> APPIiCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: / �✓� /�,���,G��R� /FYY PROPERTYia%p F M�Ta� —OD <br /> (/J y �, <br /> LEGAL�o�new ccnstmctmn Snon P�aV:uOdm;.on Lot No (allac�coOY a��ong lega�tlescnplionJ <br /> GWNER L ( �/1� Pnone�E�man �O d <br /> aa�ress n �f � c�ryrs�ate�ziv YuV � �/ � i� Z 9 <br /> APPLICANT: � Owret _OwnefSAge�l _Co�Rac:e' _CenlraclorSAgent _Te�an�t�.+ic�.*+����tn.��oico�:�nirtemmoc..,aumwn�„i+o+aam� <br /> CONTRACTOR O L 8 I Lic � COE F3u5 Lic +t <br /> AC�ress Pnarc�Em�I <br /> TENANT BUSINESS NAME CONTACT FOft PERMIT <br /> CAh/ t C�/t�� zoG 69� s6�8 <br /> Pra,c E�mad <br /> BUILDING PERMIT APPLICATION CONTRACi PRICE OF WORK <br /> Ezis'ing Use of Bm'�ding HEAT SOURCE� <br /> ProposCd Use o�wlding Gas__._. Eleunc_ Olher_ <br /> OuJtling ryFe _Single Fam.iy _DuD'eK_?oH•nhouse _Mudi-Fam��ly _Commercial <br /> Type of pro;ect Nevi AddAwn Remodel __Repair_T I._S�gn_Sprinkler_DemoliLon_Change of Use <br /> DESCRIPTION OF WORK(aao�r,ona/spare p•o.�detl on me oacti): <br /> Snnoke d ef eC�S � -}-eM��d �(u zr df -t,,�b �rea <br /> �e r T�( � <br /> MECHANICAL PE RMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol ProJccC _New,_Adan _Alteration_,Repair Typc ol Proje.t: _Ncw_Atldn _Alleralion_Repair <br /> Snaw Numecr(a)o!lirtures Show Number(a)ol lirtures <br /> NC–ar hand;ing unds irJc� <br /> Forced au syslem5 Balhtub <br /> Gas pipmg lwatory(wash basin) <br /> Watcn c�ater Sho.ver <br /> Gas Lrc0lacc Kdchen s�nk 8 d�sposal <br /> Gas ranqc Dism•�ashcr <br /> Clo�hes dryer Clothes washer <br /> Range haod Water healer <br /> Eahaust fan Smk(serv¢elbar/mvplelc 1 <br /> Heal pump Backflow p�evenlcr <br /> Urnt heater Urinal <br /> 6o�let Ur�nkmq Founlam <br /> Relrigerat�on Floor dra�n <br /> Woodstove Grcace IraO <br /> Uuctmq Roal a�ains <br /> Othcr Mcdical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Olher <br /> Number of Neads Other. <br /> I P.un�CVi cenry•hal I���e rea0 u^�e�am�eJ tn.��p�n;:o:on an0 know I��e same lo en We ana cortet� A!i Crovamas ol ldrvs an�or0�nances 9ovemin9lh.,typo o!v::M1 v:'�i pe c[rt•.,I e� <br /> v.;n nnei�er speolieE�erem c�ncl.T�e qnNing ol a PemA Coes nol F�e:ume lo A:.0.�u••..0 y'.o.c'.d..cr;:rcrl�,I-.0 pre..;on r!dn y C�rr:�.�in cr Imal Liw rri,d'�b,p ccn-.lnir�r�i <br /> icaiiariaetlonic��YNoowrcroll��,SAc"rcMloOcrlcrtnl�eworkfcrwm:� GD:a'on,.:,..�.. ricir:ly nt .:�,Y�•r,. . , . .�i.vtB2'Rlb:'a^d:- C�n•Aq:: <br /> � I y3 I� , <br /> 0�• crlAWhorizetl Agent Si9naturc �.Ie iv��'scr t�`�':! <br />