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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/Sl��NISPRINKLER/DEMOLlTION <br /> CITY OF EVERETT PERMIT SERVICES �-27 — �V <br /> 3200 Cedar St., [verett, VJA 98201 425-257-8810 FAX 475-257-8857 www everet a.org - , <br /> APPLICq710Y5 ARE ACCEPTED FROM 8 Ah7 TO 4 PM ' <br /> SITEAODRESS: /`/ 7HOPERNTA;(7Z�jvl jU� �ti/Co PER�dI a <br /> %�l�J� �r�tr7Siaa/ �L�"'�I � �Z��US/�iDOZof�ii0/. 7°Ju5"/ 'JOi ^$,a <br /> LEGAL Icr newconstrcd�on Snort PiaVsubC�v�son r'o�: n -V�✓•� lct No_ (aUacn ceDY of long legai descnption) <br /> OWNER /�� c ` l�"%y' Pnane/E ma�� ?s �,�j �I' SI�v�� <br /> nC�ress ���J 5~9 fs Ciry/State/Lp !I�,;Y�� �''J� �c5� 20 G <br /> APPLICANT:_0+.^er �Owne(sAgent _Conir�Gto� _Cer'r+�torsAye�t _ien�nt��:.ic'a.�e�n:e-e�orcnme+u�cmmec•�enoo�+����!^•:c+cei <br /> CONTRACTOR L 8 I Lic = COE Bus. Lic x <br /> ACdress Pn:^Ncmad <br /> TE�AN"f BUSINE�S NAME CpNTACT�FO VERMIT <br /> .--__ —:� /J.'n�i�=�/d�;�}//d/ <br /> .�.rj/.^-.�"n';/,`J!�.f:.iL <br /> i_--J.. _� r,r�s/ � PrCoeiE�mail���F'i �iJ- Z/�'7 i i.,:�/�' Z��iZc7.�,�,��� . -['.(o�._ <br /> BUILDINGPERMITAPPLICATION1r�are{�o615.2CONTRACTPRICGOFWORK-�v�fooa ! <br /> Exsnrg Use of 6�tld�ng!��� " � -� �' - HEAT SOURCE: <br /> i . , ) <br /> prcposedUsecf6u.'�Cmg�G�c7�E//��j�f/G�/i�ir'J:<�y/i,y�� Gav� E�ectnc_ O;ner_ <br /> Buftling type _S�agte Family _Duplex_Townhouse _Mutli-Pam�iy �Commerual <br /> Type of nro�ecl New Atldilion _Remodel _Repalr,�T i. _Sign __Spnnk��cr _Demoht on_Char.Ge of Use <br /> DESCRIPTION OF WORK(addt onai spare prov,ded on fhe Dacw) <br /> _ � _ _ _ ._ ._ <br /> - � ri • :/ /��r�-�1��� /S�S . <br /> , 1 �— _ <br /> -- - ; -J_'�'�115 . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type o�Pmjec[: _New_Addn _Allera�ion_Repalr Typc ol Projett: _New_Addn _Alteralion_Repair <br /> Sho�v Nurn6cr�a)ot lixtures Show NumCer(ttJ ol l�xfures <br /> NC -av h:�diing umts To�let i <br /> Fo�ced au s stems Hathtub � <br /> Gas pipmg Wvatory h•:ash basin) <br /> W91C�tleaier � Sho�.ver <br /> Gas freplace Kdcl:en,inh R tlisposal <br /> Gas ranqc D�5hwa5her <br /> Clothes dryer Clothes washer <br /> Ran9e hootl 6Vater heatcr <br /> E.haust lan S�nk(scrv�cclbarlmo retc 1 <br /> Heat pump Oackliow preventer <br /> Um(hc.ter Urmal <br /> Bo�ler Dr�nking Founta�n <br /> Refngcrahon floot dram <br /> Woodslove Grease trao � <br /> Du[tin9 Roof dia�ns <br /> Other Metlical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Otner <br /> Number of Heads Other. <br /> inveoycen�rytl+ail�avertatlanEciamNeOVi�sapp�wlo^anE�nowme;ameto�cUuea�tlm�rer.i Airyovrs�on:ollawsandortl�naneesgorcmingNrslypeolwo�AwAlbewmpicd <br /> nanr�netnerspeofm0�erenornot T�eqrJnLnqolapem�dEoesnotpresumetogneaulno�lylovqiNear�lncellhepronLonalanyot�erslaleartowlUwre9uUtnpmnsWcton <br /> Tlul I am aut�onieU by Ne mmer ol lbis prapeM�o pl�orm Ne aod lor w�r7�epD'-����s ma0e an0 I comply vrtN Ine Sbie Co�'�aclors L��1 B 77 fEC W and 296:WA tNAC <br /> '�~ � � f � �`� <br /> ��-�::�/'r�f j��'�/ l/�� r �7J., / / <br /> �OwnedAulhorized Agent Sjgnature Dal (F?visnd ER07?) <br />