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' �RMIT APPLICATIO <br /> BUILDING/MECHAI�ICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SIT�� ADORESS: PROPERN TAl(p PERMIT# <br /> oao3 D�ICotG (/��• SSaYoo oi 50�- 0�5 <br /> LEGAL lor new constmct�on Shon Plat�sabtliva�on Lot No lallach cepy ol long legal tlesaiptionj <br /> OWNER Q,y,� Q e PhoneiE•ma�l ya� - a o-4y o3 <br /> �da�t55 (0�03 ll� C l,Jo. ��,Y,s�,���z�P �e�ef�, (,tlf} 4a'�o3 <br /> APPLICAMT: _Owner _ Owner'sAgent �Corlraclor _Con�raclor'sAgent _ienanttT�sio:���,:..,,�.r�,��U,�,<��w,nm.��.��..rmuo+-n�„n,.,n:.c.� <br /> CONTRACTOR 2 \/1 L Sl�te lic. K 2 J�* �o� 1'�rn C��Y�us Lic #��� Q�p� <br /> ��,a,�55a�aai �d � E �� �f�n � P����,Em,� 3�o- y3s-y90 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �hK�r����� �uzy ��'�nU 36o-y'3S- yq�`/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �� � ` <br /> Lxistina Use of Building HEAT SOURCE- <br /> Proposetl USe of Builtl�ng Gas EleUnc Other <br /> Budd�.ng rype� �Singlr. Famdy _Dup!ex_Townhouse __tdulti-Family _Commeraal <br /> T e of ro ecf New AddiUcn Remodel Re air T.I Sqn S rinkler Demolihon Chan e of Use <br /> DESCRIPTIONOFWORK(atld�ronaispaceprov;tleeonmenackr , <br /> �n5+� I I d� I Z �� d��t-l�ss h Pw� 9��P <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Pro�u[t: _Now Atltln _Altorellon_Ropalr Type o1 ProJoct: _Now_Addn _Altoratlon_Ropair <br /> Show NumOer p ollirfures Show NumDer '7 of/ixltnes <br /> NC—au handlin unils Toilel <br /> ForceA art s Stcros f3alrtub <br /> Gas i m Lavator wash basin <br /> lNatcr hmter Shovrcr <br /> Gas Gre lace Kdchen sink 8 dis osal <br /> Gasranne Dishwashcr <br /> Clothes d er Clothr,s washer <br /> Ran e ho0d Watcr hr.alcr <br /> Fxhaust(an Sink servitelbarlmo 1Mc <br /> I lcal wn Bickllow revenler (ins�de bltlql <br /> Und heater Urinal <br /> �adci Dnnkm Founlain <br /> Refn Cration f'Iwr drain <br /> Woodslove Grease tra� <br /> Uucl�n Rocl drains <br /> Olhcr MeAical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM otner. <br /> Number ol Heads Other _ <br /> I nr!Pcy cerL!y It�al I ttdve�edtl anu�W mmeA Ii�is apo�'ra!ion dna knaw Ine same lo be in�e an0 cortecl All pwvisions cl Idrl.ana oidindnces goveminy Inis I1Dc ol��o. w0�r<�n'P <br /> w��waether sDeot�ed�Pie�m er not Tqe�ranlmg ol a V^nnu does nol0«sume'o 9rve aulnonry lo viaUle o�wncel tne pinvrs�on ol any ol�a sta'e or lucal law ie9uWLn�censbu:.Lon <br /> Tl:ai I ain autnoune0�y I�e onn 11�is p�opert�lo peAoim Il�c wc�t lo�wn�ch appl�calron�s made and I compp w+lh�he 51a1e ConlmUors Law 1817 RCW and 29G 200A LvnC <br /> , ����-�s� �� z <br /> OwnerlAu(horizeC Agont Signaturo Date (Ftev�sed JR0151 <br />