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. � • � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , Everett, WA 9820 i - 425-257-8810 - FAX 425•257-8857 -�wnv everettwa org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �—��"�� <br /> SITE A�DRESS' ��O5 �3�I1 S�. EV2f@(�, WA 98201 PROPERTY TA%p PE IT a <br /> LEGAL tc•ne•.�ce^str��cucn Snon PiaVsuhC�v�von �e�No_ (avaU woy o�ion9 tegat CescnoLcn) <br /> OWNER EVERETT PORT OF rha�e�e.ma�� <br /> aaa�ess PO BOX 538 cnv�satc�z�c EVERETT, WA 98206 <br /> CONTRACTOR Reliance Fire Protection L81LiC a RELIAFP 102L1 <br /> �aa,�ss PO Box 428, Preston, WA 98050 ano�erema�i 206-682-6636 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Isis Pho�e�E_m�,� mike@reliancefire.com <br /> BUILDING PERMIT APPLICATION CONTRACT aRtCE OF woRK 500 <br /> Ex�s!�ng Use o(Bu�itlmg HEAT SOUFtCE <br /> Praposed Use of Buiiding Gas_ E!ecinc_. Omer_ <br /> Bulitl�ng type _Smgie Famdy _Dupiea_Townhouse _Wulh�Famny _Commeruai <br /> Type of p�o�ect _New _Adddion _Remodel _Repair_T I _S�qn_Spnnkler_Demohtion_Cnange of Use <br /> �c'SCfIp�lOn 01�VOfk(�C��hJ�al SpaCC p:Ov�tleU on the OacF) <br /> � Cry� � "`�V <br /> Havc you started working wilhout a permitl _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pro�ecl: _New_AtlOn _Alterabon_Repa�r Type ot Projecl' _New_A�tln _Alterabon_Repau <br /> Show Numbci�aJ ollistwes Show Numbcr(nJ of firlures <br /> NC—a�r nandi�nq unds loiiet <br /> Forced a:r systems �athlub <br /> Gas p�ping Lavatory�wash bas�nl <br /> Water t�eater Snov:er <br /> Gas hrepiace K�tchen sint 8 d�sposai <br /> Gasrange O�shwasner <br /> Clmhes dryer Cl0lhes washer <br /> Ranqe hoo� Water heater <br /> E.hausl fan Smk (sr.rvice�barlmop�elc ) <br /> 11e.1t pWn �ackflo:�prevenler <br /> Und hCdlCl � Unndl <br /> �odcr Dnnk�n�founla�n <br /> Reingcrat�on Ploor diain <br /> 1Noodstove Grease trap <br /> Duclin Rool tlrains <br /> Other Metl�cal Gas <br /> SPRINKLER / SUPPRESSION SYSTEM O�ner <br /> � Number of Heads 4 Other <br /> i ne�eby ceney mai i na�c reaa and exam�nea m�s aPpi�caimn and Mno++tne same to be v�e��a co«ect nn pro��s�o�s o!�a,:;�na cre,na�ces go+c���-g <br /> tn�s type ol.wrk H+il oe compheE w+t�vMeiner specd�ea here�n or not 1ne gianung ol a permn tices no1 presume to grve auR�c��i�te vroia�e er canco� <br /> Ine p�ov�s�on ol any other state or laal law�eguiabng cons�mcl�on or Ine pedo�mance o�coos�mchon That I 0m 0ulhon¢etl Cy the on^e�e�IOS D�nOeny <br /> ro peNo�m tne no�k for��nicn appi�cat�on�s matle and I mmpiy w,ih the.State Co�vacto�s law iB 21 HCIN and 296 2�0�4�AC <br /> �zrilre osiosizo,a <br /> OwnedAuthoriied Agenl Slgnature �ate I�ev�se9 '_�:'U��) <br />