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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES //-3 O — �2 <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 5 EADDRESS: PROPER7VTAXN PERMJ,T(F' _ <br /> 32� (�;<< r,��r A T 'z� 3 OJ o o� L- <br /> LEGAL br new conslruction: Short PlaUsubdrvision Lol No. (altach copy of long legal descdption) <br /> OWNER �y /a T T 3: I Phone/E�mail �/Zi-'ZQ • �/$SD 9Gl CJn1 ' � � <br /> Atltlress � 2 7 ';;3 � , � �� Ciry/State/Zip <br /> APPLICANT: Jvmer Owner'sAgent Contractor Contractor'sAgent Tenan!(musipravNeektkrofmnsenlhomC��onnwloCov.v�l�Ne�paca) <br /> CONTRACTOR O �Z � �! ' n-� Td/i L&I lic.# COE dus.Lic.# <br /> Address ' !�- P�one/Email j�f{ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> C'�36 c�✓�3�e e Y <br /> PhonelE�mail — 706 !' C��� ��� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK '�J,.�nn '" <br /> ExiS�ingU5eof8uilding i28��1 ��3��T7A �. Su�!Gt,6 Fcppn��y HEATSOURCE: <br /> Pmposed Use of Building iZrfS'= Ai,j�•� 4 L ��n]LLb Y�/1Mil.v Gas � Eiectnc_ Other_ <br /> Building type: �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of pro'ect: New _Addition Remodel _Repair T.I. Si n Sprinkler Demolition_Chan e of Use <br /> DESCRIPTIONOFWORK(additiona�spaceprovrdeeontheback): 2� Kre� C�'%FA/AN/. <br /> �j.�l 'S!� ii�"�2�yldJT �iV1�i. S�L1C' �',31�C�C3 G�C vT_./*�J.�i� <br /> .qDD/n_�c�cA-;�/ <br /> W i�r J � ,��CI'y1t1J(� �Jur`LS u��l)4-F� LLSC7/�1 c1G� C�- ;,d71n/Co <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoolProJect: _Now_Addn �'Alteratlon_ftopalr TypeolProJecl: _New_Addn �Alleratlon_Repair <br /> Show Namber(01 0/lixfures Show Num6er�B)o1lLrfures <br /> � A/C-airhandlingunits ? Toilet <br /> / � Forced air systems Bathtub <br /> r � Gas piping 3 Lavatory(wash basin) <br /> � Water heater Z I Shotver <br /> Gas fireplace ,� Kitchen sink&disposal <br /> Gas range '1 Dishwasher <br /> 2 Clothes dr er � Clothes washer <br /> � Range hood <br /> � Exhausl(an d Sink(servicefbadmop/etc.) <br /> p' Heal pump �f BackBow preventer <br /> Unit heater I Urinal <br /> Boilcr . Drinkin Fountain <br /> Refrigeralion d Floordrain <br /> � Woodstove Grease irap <br /> � Ductin Roofdrains <br /> � Other �c' MedicalGas <br /> SPRINKLER I SUPPRESSION SYSTEM Other. <br /> ,C�' Number of Heads Other: <br /> fI imreoy cenity Ihat I havo rcad nntl exomineU INa npDlkutbn and knmv the samo lu Ce Imo and cortecl.M pmrisiona ol L��n enC ordinencm Boveminp t�is ypa olwork H+A Oa compOeC <br />� v:ehvrhellicrspecifea0crcinotnoLihoBrantinpofoDertni�doeanolpmsumolopncuulhonrylovioWleoreoncelNeprovisbnolnnyoNerstalBorlorallawrepWtinOaons�rucllon <br /> lnal I am aulhonzM 7y tho avmer olNie pmpeM lo peAorm Nowork lorwnkh aOPfi�ntbn le maGo enE I wmpy w4h No dtnto Contmclon law 1827 RC\N anE 298.200A WAC. <br /> 1 % . . � �� [� �i /,1 C) /2� <br /> `� Ovinar Authorl2ed gedl S nat c Date (Revised Ne"011) <br /> � z <br />