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From: � OS/`�12012 09:39 �690 P.002/002 <br /> ` �" i �� �� <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKi.ER/DEMOLITION <br /> CITY OF EVERE7T PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257•8810—FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM S- O �- �� <br /> SITEADDRESS: 2� �`��r PROPERTYTA%11 � _ <br /> �� �r�� oo l�oSol3oo <br /> LEGAI lor new mnslrudiore ShoA PlaVaubtliWsion Lo�No.__ (atl0c�copy o�IonOluqnl tlasvipllon) <br /> OWNER o� Q..Y Phone/E-msil p�� • I ' . O�qI � <br /> tldresc p�3� �Ve1-�1e- t � `� CIylStetalAP V el� W t �+�� 1 <br /> CONTRACTOR ►V Q. L 61 Llc.k I I G • W $ C <br /> tltlross '[W� 1 �JZ r1�e � �� Q.VL W 3-1 P�«'dEmall ,7 <br /> TENANTBU IN 5 NAME CON ACTFOR ERMIT �IZS �03�0•7 <br /> �uGc Cas . `� . cawl <br /> P�one/E-mall t 0. Q <br /> BUILDING PERMIT APPLICATION CONTrucT PRICE OF wORK S•� <br /> [xistinp Use of Buildin8 � �"�� HEAT SOURCE: <br /> Proposad Usa pt�uildinq Ga� EIec�Ac� Olher_ <br /> Buildingtype: �SlnpleFamlly _Ouplex_Townhoybe _Multi•Famiry _Commerciel <br /> TypaofproJecl: _Naw _Additlon _Remodel XRepeir_T,I._Sign_Sprinkler_DemoiRion_Change otUse <br /> Descdptian ot Work(etldRlon�l spece provltled on tbs Dacp: <br /> I�e.c�o�c�� reP�0.ce �lec-�-�-',c. w c�-�e.� 1�.e.Q�� <br /> H�ve you started workinp wllhout�pertnit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> iyp�ol Project: _New_Addn _AlbnUon_R�pair Typa ol ProJ�ct: _Now_Atldn _Al4ntio Ropair <br /> SAowNumb�r(1' o/flaYuns S�owNumbe� Jo/Orfuns <br /> AIC-eirhandlln unita Toilet <br /> Forced elr a slems Balhtub <br /> Gas I In Lavato wash basln <br /> Watet heater Shower <br /> Gas fire laee Kitchen sink 8 dis sal <br /> Gas ran e Dishweaher <br /> Clothes d r Clothes wesher <br /> Ren e hood Water heater <br /> - Exheustfen Sink servieelbar/mo lotc. <br /> Heat um Beckllow reventer <br /> Unit healer Udnei <br /> Boiler Drinkin Fountein <br /> Refri eralion Floordrein <br /> Woodstova Greasa tra <br /> DuAin i Root drai�g <br /> Other Medical Ges <br /> SPRINKLER/ SUPPRESSION SYSTEM othcr: <br /> Number of Heads Other: <br /> 1 here0y ceNry tl�al I�eve reatl eM euemined l�le apDb��bn and knowlhe same to be Inio and cortad.Atl provi�lons of tawa ara oNinancec yoveminp <br /> lhts type ol unrk�N�I be complied w+lh v,helher sped0ed herein or not.The prenlinp ol a pemtlt Coa�not pnaume to flWe eutho(ity to violale or qncel <br /> Ihe 4rovialon of eny olher slata or locel law repulaUnp consWcUon wthe pertormance ot consVueUon.TTat 1 am aul�orired Oy tho w.ncr ol lhis pmperty <br /> to peAom�lha NaN tor whkh appiution If mada and I tompy N11�the Stoto Conlraqors Law 18.27 RCW md 2D8.20�WAC <br /> .�1�; a�'✓�- 5 �a <br /> narlAuthodzatlAp�nt pnNure Oate (Revfsed7l201f) <br />