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. � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBINGI:iIGNISPRINI'LER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereri,WA 98201 -425-257-8810—FAX 425-257-8857—vnvw•everettwa.o�9 _)2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AtA TOI PM pp��,, Z ` <br /> PROPEflTY TA%b PE���Z�� <br /> SITE ADDRESS: : <br /> :� ,.• •:i-r �,; �.. � ` ir � <br /> LEGAL for new cansin¢tiort Short PlaUsubdrv�;ion Lol Dlo__ iaMach wpy ol long icpal descnplan) <br /> ' ?� S phor�e�E�mall <br /> OWNER �r��..?,.. . ':iiJ�l�t { � /_ �i ^ .9�tc: <br /> =�i•:%�t'fL.. Cdy'Stal¢2�P � ✓rie� . r � <br /> AakLess j�� •�+ot �� ��r�r rt '• <br /> CONTRACTOR J�G_� �i � T� . -�rir L 8 I UC.# :!r,�• : � ;rn.3 % 1 �. <br /> ../�;� �. / � ,r. %i ', ,�"`/' �'�� PhoneiEmail <br /> Atldiass " r: � <br /> � CONTACT FOR PERMIT <br /> TENANT BUSINESS NAME • � t,� <br /> i .C�� L .-rf-' ��°�S <br /> �,/,'� .i . •ql <br /> phcnc:Gmail ' � <br /> BUILDING PERMIT APPLICATION <br /> CONTRACT PRICE OF WORK ��'� F �' � ' <br /> F1EAT SOURCE: <br /> E�isUng Use ot Buiidmg -'— <br /> Gas Eledrk O�har <br /> Proposed Use ol Buildm9 <br /> �wldmg type: _Singia Famtly _�uplex_Townhouse _Mulii-Famdy _Comme�cial <br /> Ty�x ol pro�ecP �Ne�v _Addition _RemoAel _Repair_T.I._Sgn_Spnnklcr_Demolilion_Change ol Use <br /> �l�• . . <br /> DesaiplionolN.'orkl�'tioralspaceprovdetlondreheck): �-�•n a', - .i� ;.��� le..�t. . � - r.� <br /> :r ' ;'� 't' <br /> 1 ' J`- I itii,i i�t��/v�i.�� uii� /•':C�/�A � rt.� [��.'/ .7 <br /> � i '. /i � � / / <br /> � ��nl �� �.. .nl . � �i`�n�6 �J /ll������S.��y ��'.�H �� ���J�t �t/'l� $.lCul� .. � . <br /> �: t,-:� r! t . � J <br /> Have you started workmg wilhoul a{xrmll7 f YES �No PLUMSIN(i PERMIT APPLICATION <br /> MEClIANICAL PERMIT APPLICATION <br /> TypeofPwject: _New_AJdn _Altantlon_a�Wir <br /> TypeolProlect: _New_Addn _A�te.ration,_RcPair SM1owNumbar X)olfixtures <br /> Show Nnmber(p)of lirtums Todel <br /> A!C-avhantllin units paihlub <br /> Fomed nrt s slems Lavator (�'�ash basin <br /> Gas � in Shower <br /> Water hearer �:i�chen smk 8 tlis sel <br /> as'irepizce � Oishwasher <br /> Gas range Gothes wasner <br /> Clotnes tlr er Waler heater <br /> Hanqe hood Sink�vrv¢e�bar.'mo fetc. <br /> E+�h�usl lan � Backtlow re�+entet <br /> Hea� um Unnal <br /> Unit heate� Drinki Fnuntain <br /> �01�zf Floor drain <br /> - Relriaeiation Greasetre <br /> Wootls�ove Rool Orains <br /> Duchn <br /> `1t 2f N.etliwl Gas <br /> SPRINKLER / SUPPRESSION SYSTEM <br /> Other. <br /> Cther. <br /> NurnUer ol Heads <br /> I hewEy wtlAy Ihat I nnvn�ead aM oiamined t�ua appliv:lion and Anowtham ti�t��t°1° t dues`rrot pos�me lo Gi�o'oum nh o violato or encel'^9 <br /> this typu o1�wik�yill be complKd��Ah��irother specdwc•Mrem�r not.Tl+o 9 ^9 Pa <br /> Iho pro�s�on ol any othcr stota or Wcol Iaw wpuWUng coi.:truc`b�thc St�e Cont acto s�Ww`18 27 RCVl'alrW 290 200W GY No amor ot this P�P�hY <br /> to pohoim ths wciklnr�•.hich a�bcation n mode and I comply <br /> .� <br /> . ��' � � �.� : %���'�'/ ' �Revued7l:�11I) <br /> OVA�edAuthmxed Apmt Signatum <br /> � Dat� �'-' <br />