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�F�t�91' A�'F��.3��T'I� �� <br /> BUI'�.DINGIMECHAdVICALlPLUMBINGISIGNISPRINK�ERID�MOI�ITlON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Si., Evereti, WA 987_01 425-257-68 i 0 PAl: 425-257-8857 wvn�a.ev�ere�hovZa.l rg l C <br /> / <br /> SITE ADDRESS:� PHOP[RT�7AKN �EI�T�n � ��� <br /> lalf �1�1L�2�'�c-L� � .�.''2 . '� T� <br /> LEGAL for nr�v consiruction: ShoA PlaVsubJivislon Lot No._ (etlach capy of Ibn9legal descripli=n) <br /> OWNER .�� _(,,� J . �I' PhonelF�mail C ' '7 � ` � <br /> ��--- -� ? <br /> nderess �� oz31W1-e(�elG �' Ciry�slate/Zip C �'`e. (,C.� �a� <br /> APPLICANT:_O�,vner _OwnefsAgent _CoNractor _CenlradcfsP.gert _Tenant�c.�uv���-��i��:crmm�som!rv�,c+ec«r.enoe�r����nm�:p��tJ <br /> CONTRACTOR (' State Lic.N City Bus. Lic. H <br /> � PhanelEmall <br /> AddrnsS <br /> CONTACT FOR PERMIT <br /> Phan^!c�mai� � <br /> BUILDING PERMIT APPLICATION CONTRACT PRII:E UF WORK _— <br /> Ecisting Use of Ouilding _ HEAl SOURCE. <br /> Proposed Use of�vilding� _. Gas___ Electnc____ Olnr_ <br /> Building type: �Single Family _Duplex Townhouse _MWti-Family _,Cocimercial <br /> Type of project: New _Addition _�Remodel �fiepair T.L_ _Sign_ _Sprinl:ler_Demoiition_Change of Us. <br /> DESCRIPTION OF WORK(acd:rionalspa�p�rovl�lon thc b�ck): <br /> �� t'��oG� :i r- 1� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PF_RMIT APPLICATION <br /> TypoolProjecL• _Nuw__Addn _Al�eraUan_Repair TypeolPro�ect: _New_Addn __Alteration_Repair <br /> Show Numbcr(N)ol firimcs Show NumCcr(NJ a!fiaYures <br /> A/C–air handlmg un��ts Toiict <br /> ForCed air sys'ems 8athiub <br /> � Gas piping lavalory(H�sh basin) <br /> Woter heatcr S�ower <br /> Gas fireplace Kitchen sink&dispasal <br /> Gas rangc L'ish�sasher <br /> Clothes dryer Glolhes washer <br /> � Ran9c hood VJatar heater <br /> Exhaust lan _ Smk (service/barlmop!elc.) <br /> Heal pump (3ack11cw preveMer(inside blJg) <br /> UNt healcr Unnal <br /> Uallcr _ �rinking Pountain <br /> NefrigeraLan � Floor drain <br /> �_ Wnodstave � _ Grease trap <br /> � Ducting Rcof tlrains <br /> � Othcr _ t.iedical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Numbcr et Ncads otner. <br /> I hercGy cen�'y lh•it I n ive rr.ad and exatn�neC mi;appbca�ion and know t�e,ame to Ce tme aod eortttl All prcrisbn%ol laws and ardinances 9oveming Ihis IYPe cl nork wi I Cu campfeJ <br /> w�th xhetAcr�pcuSeJ herein or nol.TPe c r.ti,�9 of a penn.l doxs rcl presumc lo gse aNhonly lo violate or caneel the p�aviscn ot uny alAer sla'e oNowl Ww regu�a!iny cansiructian <br /> Th,-,t1� autt�mced6ytheox�i �a(I 'sp .Fmryto +d ml�ewa�k(arw�ichappllcilionismadeandleompyHiRi���e5tatoConVaclmsLaw1o.27RC�Yandz762ooAV�'AC. <br /> � �al�s� <br /> � _ ��,� IRevised4/1015) <br /> OwnerlAutho edi3ent5igiutw <br />