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From: 02/'�I2012 12:a1 �469 P.002I002 <br /> �� ���-I-`lo 1 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICA.L/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> Cli Y OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810– FAX 425•257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM!AM TO 1 PM ,�. �/ `�� �. <br /> SITEADDRESS:nrOr� \; PROPERTY �O LO ' r P IT,N2Q �I <br /> OS✓ ✓ � `I Z' <br /> LEGAL tor new eons�mciion: snon rievewdrvi�ion Lot No._ (etlw:h copy of lony lepal Oeeaiption) <br /> OWNER n PnonvE�mell Zl..�p� �J O�-�p <br /> atlress 2503 � ��C�' �� CIIylStalelZlp �e�e� '� uZ�� <br /> CONTRACTOR ►V�, L 31 Ue.N �I G • W S C <br /> � ��a{/� 132 A'�e � �� Q�'� W �� P�onal[mail .7 <br /> TENANT USIN 5 M ONTA T FOR ERMIT t�u �3� 7 <br /> �. �ulte Cas . '� .carvl <br /> �� � „�l P�ondE-mail � 0. �Q <br /> BUILDIN6PERMITAPPLICATION coNTRACTPRICEOFWORK I 2�0�"— <br /> Existing Use of BulldinB � C'e— HEAT SOURCE: <br /> Proposed Use of Uuilding Gas Eieari Olner <br /> Building type: _Single Famly _Dupkx_Townhouse �MuIU•Family _Commerdel <br /> Type of proJect: _New _Addition _Remodel�Repeir_T.I._Slgn_Sprfnkler_Domolilio�_Change of Use <br /> Descriplion of Wotk(eddttbnel spec�poWded on(ha nadQ: <br /> �e��� �\�.e� �1ec-��..�c v�cr�-e-T ��� �� ����-4- U_ <br /> Hava you sbrtad workinp without a pertnit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pro)ecl: _Naw_Addn _Altontlon_Repalr Type ot ProJact: _N�w_AdCn ,Attention R�palr <br /> SAowNum6cr olArNres ShawNumC�r(N o/flxWre+ <br /> A/C—alr handli units Tollet '�, <br /> Faced air s slems Bathlub <br /> Gas i In Laveto wash basin <br /> W aler heeter Shower . <br /> Gay fire lace Kitchen aink 6 die sal <br /> Gas re e Dishwesher <br /> Clothea tl er Cblhes wesher <br /> Ren e hood 1 Waler heatef <br /> Exheuslfen Sink servicalbar/mo /etc. <br /> Heat um Backilow rewnter <br /> Unil healer Urinal <br /> Boiler � Drinkln Faunlaln <br /> Retri eration Floordrein <br /> Woodstove G�naso tre <br /> Ductin Roof dreins <br /> Olher t Mcdical Ges <br /> SPRINKLER 1 SUPPRESSION SYSTEM other: <br /> Number of Heads Othor: <br /> I Aoreby cehlry thal�have read and axaminod Il�is appliwtlon and knowthe same to he trua ena cortect.A110�isions o'Iaws and wEinances 9ovemirq <br /> (his type ol�+urk will be Comptle0 vAth Whelher apBafletl heRin or not.Tha prantinp ol a pamil does nol pfesume lo glve a�!hotily to vb�ale or cancel <br /> the F�Wsion o1 any other ateta w loeal low ropuleGnp coneWcUon w tha peNumance of conalnxtion.Ttul I am aW�orixeE Dy Lhe wmer ol thia poperty <br /> to perloim Ihe nork for�Mlch appllcalion Is made end I comO�Y��h lhe Stale Contractors Lew 18.27 RCW and Y08.200 WAC <br /> ,t, ���- h'13�12 <br /> nerlAulhorl:;tlABo�� p�aturo Tate (Rovisod7ltOf7) <br />