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' <br /> . � � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -42&257-8810-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �- GI— <br /> SITEADDRESS: aDS !� � � Pp�PERSYTA% p�� �3�� T D <br /> u. s� ooao? oo i <br /> LEGAL for new mnstiuction: Start PleVwbdivisbn La No._ (attach copy W lorq leqal CescnpGon) <br /> OWNER o�t o� �ve✓'e �^��""'' -°� - 3 / <br /> � �os e��h�ua., t�1a st-c �.e o ��ry,�.��o v�r�11� 9 �o G <br /> CONTRACTOR � �'S tf l � L 6 I llc.N i G�-r�M 4 � <br /> a�o S`P- i.3 - i3i ffveNE L.� e.sY��e•-� �i.�. ���� ��S-33S-�ae7 <br /> ENA U I NAME N 0.� ' ipSO/1 — � ' S '�ISI <br /> !,�la�c�e �rn�tfG�t,e- ��eGa.. �-�� . f• e., • �� <br /> BUILDING PERMIT APPLICATION coNTr�cT aRiC OF wowc S /9 .t3" <br /> Existing Use of Building OF i CG�/S o o sefr'�vrC.e.- R� • HEAT SOURCE: <br /> Proposetl Use of Building SQ W1 G \r( — D r��C! CI�.SS/ Gaa Elearie �ther <br /> Buildingtype: _SingleFamily _Duplex_Townhouee _Multi-Family �Commercial <br /> Typeotproject: _New _Addition _Remodel _Repefr�T.l._Sign_Sprinkkr_Demolition_Change ofUse <br /> Descriplion of Work(addrtional spece provided on Me beck): V <br /> t <br /> Hava you atarted working without a pertnit9 YES �NO <br /> MBCNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeotProJect: _N�w_Addn Ibntion_Rapelr TYW�PropcC _Nw+_Addn _AlhrWon_MpNr <br /> ShowNumber o/flxtuns SAowNumbr )o(flxtwu <br /> A/C—airhr�tllin untts Toikt <br /> Forted air s lema Bathlub <br /> �� Gas i in Lavato (waah basin) <br /> �� Water heater Shower <br /> Gas fire lace Kitchen sink 8 dis aal <br /> Gas ran e DisMvasher <br /> Clothes d er Cblhea washer <br /> ,Ran hood ' W�terheater <br /> Exhaust fan Sink servicelGr/mo etc. <br /> Heat um Backflow reventer <br /> Unit heeler Urinal <br /> Boiler Drinki Fountain <br /> Ref' eralion ' Fioordroin <br /> Woodalove ���� <br /> Ductin Root tlrains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION 8YSTElYi Other. <br /> � Number of Heads Other. <br /> I hereby certify that I have read anE examiMtl Mis eppli�stbn and know the aame to be true antl cortect al G�'isions of laws antl ordinGrrAs qovxninp <br /> thi5 rype o(v,otk Nill be comPlied WiM wfiether apeCified heiNn or not.Ttw prentinG o}a permit doea ral prewme t0 Bive aul�ority W violate w cencel <br /> - t�e provi5i0l1 013f1y WhEf Slal@ Of b(',1 IiW IlCulilifl0 WfIfWC�IOfI Of�l!pQf�Ofi1KI1L!01C0lIShUCS10f1.T11iI I iRl WIhOl��'�1!O'MMf O�MiS�Op81ly <br /> ro pertorm the Mork for whi PW�fion is made and I complY N+Ih the Stale Co^Uacton Law 18.27 RCW and 296.200 WAC <br /> _ 9_�d _i( <br /> erlAut�ori�tl Agant Signatun Date (Revised Y20f 7J <br /> (�2 <br />