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� � <br /> PERMIT APPLICATION <br /> • BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 425-257-8810 FAX 425-257-8857 �vww.everettwa org <br /> 1/�i5� / <br /> SITE ADDRE55:p�-� PHOPERTV TA%N P M1��T# <br /> O b E/lZf�'� /�/ ODL fs�- CIC�OI7AO I — D <br /> LEGAL lor new conslmct�on�. Shon PlaVsu6drvision Lot No._ (attach eopy ol long legal descnplion) <br /> OWNER �( _ � �j/�..V,Q-ri/T Phone/E�mail G{Z�,�N � <br /> Atldress ��j CilylState2ip Gv�(.�y('(- y�/p <br /> APPLICANT: Owner Owner'sAgent �Conlraelor Conlraetor'sAgent TC�30�(mvsiprordaaleuerofw�senitromtnoownertoEowoMininnspa:e� <br /> CONTRACTOR i � P�um +JG d- ' T . State Lic. N �/�yn/� N Y�� c�Y e�5. u�. n4(R N <br /> Atldres5 �(p � J , GtJ, L NNU� 'T D��� PhonelEmail y2�-��(p <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT�O"� /J��,� <br /> �"Y f� <br /> Phone�E�mail y25-�5-Gyi <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK`� iQ� <br /> Existing Use of�uilding H[AT SOURCE: <br /> Proposed Use of Building Gac_ Eiectric_/� Oiher__ <br /> Building type: �Single Family _Duplez_Townhouse _Multi-Family _Commercial <br /> Type of pro�ecl� New Addition _Remodel _Repair_T.I. _Sign_Sprinkler_Demolilion_Change of Use <br /> ESCRIPTION OF WORK(aAtlmonai spacc providetl on fhc back)�. �5�R.LL ���� ��C��G /�"�1� <br /> H�ar�o��i2—� �}-,vp ,g- N�u,c� �i�rr,-r� ff-�-T Pu�wP, <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol ProJoct: _New_Addn �1ltaralion_Repair Type of Pro�ect: _New_AJdn _Alteralion_Ropai� <br /> Shav Number(a)ollixNres Show Numbcr(a)olli+fures <br /> A/C-air handhnq unils Toilet <br /> � Forcr.d air systems Balhtub <br /> Gas p�ping I Lavalory(wash basin) <br /> Water neater Shower <br /> Cas freplace Kdchen sink&disposal <br /> Gas range Uishwasher <br /> Clothes dryer Glothes washer <br /> Ran9c hoad Waten c�ater <br /> Exhaust fan Sink(servicclbarlmop/cic) <br /> Heal pump Backfiow preveMer <br /> UNt healcr Unnal <br /> Boiler Drinking Fountam <br /> Reingeration Floor drain <br /> Woodslove Greasc trap <br /> Ducting Roof drains <br /> Other tdedical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Olher <br /> Number of Ileads � Olhcr. <br /> 1 hemby cendy Ihit I havc rcad and exnmincd Ih�:.�DG��u�tion and Ynoa I�o samo to Eo INe nnd<nrreq All provisions ol I.iw,ind ortl�nances 9overrnng tArs type ol work�hll Oe r.omp6cn <br /> xitp w�elher specAleO perein or no1 TOn gmnlinA o1 n permA dces not presume Io qrve aWnonly lo v:ola!e or cancel tho pmvivon ol•lny al�er sld!e or Iocal lan Ie9uInLn9 ce��stmU�on <br /> 1hn1 I am auRiontcE 0y Ihc owner o11�19 Droperty to per/onn Inc wotA Icr w�irh appLtahon 1;macic an01 mmply v;'b�no italc CON�aclm;Law 1U 77 HC,VJ ancl 2Ufi�OOA V.'AC. <br /> `�`��'�— - l��✓��j <br /> OwOor/�od2etlAgontSi�J luro `� n� C ;11ovc:,.dJ:'01?I <br />