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Jun 09 1502 55p • P � <br /> � <br /> PERMIT APPLICATION <br /> BUILDINGlIV�ECHANICAL/PLIJMBING/SIGN/SPRINKLER/UEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 9820� 425-257-8810 FAX 425-257-8857 www.everethva.org <br /> -lD-i S' <br /> SITE AD�RESS: PROPEflT'f TAX k P I <br /> ' C_vrY-� ��rd f��� I - (7 <br /> LEGAL lo:ne.v con3Wdion: Slr�rt PlaVsubdrvison Lot No._ (altach c�py of I�ng legal oesrnp�on) <br /> OWNER � !�I �,v L� I 1 � Phone/E�mail �-s- a 3 g -4 a1 � <br /> nda�ga 15� � �-4V�'�bCct-p� f�-V`�- tttv�statezP lG�l<-' /Y-' Cf (,(�GZ �! �S a-� <br /> APPLICANT:_Ovmer _Ow"�.eYSAgenl _Con�r3C10' _C�nV�cloYSFg(;nt _ianaOl(mr.ipm�icoair.wro�:�nwmrominoowerm<cwrtinnuqa-�ni <br /> CONTRACTOR � State Lic.i1 City Bus. Lic.# U y2 <br /> AaCrtl55 Phone/Ertu�1 <br /> TENANT BUSINESS NAA1E COry TACT FOR PERMIIT <br /> J uscr � 1��,b�Uas-�a�Foa� <br /> Phane/6moa � YC�S�V1n.�1ln@�L�/V�[G+ S�YL'LX <br /> BUILDING PERMIT APPLICATION CONTanCTPRICEOF WOrxK ����- <br /> Eristing Use of Building HEAT SOURCE'. <br /> Proposed Uso of Building Gas Ekcrti_ _ Olher <br /> Building rype: �Single Famiiy _Duplex_Townhouse _A1u'�ti-Family _Cammercial <br /> T of rded: New � AAdilion Remodet Re air T.I. Si n Sprinkler Oemolilion Chan e o1 Use <br /> DESCRI PTION OF WORK(odCilicnal spnec provided cn rhe bacw�. <br /> /-�- d d r'}-c r,c�� °�- �'-e��a ce. -e,x�s�-�� �u,Y +�,..cc c� <br /> MECHANICAL PERMIT APPLICATION PLUMBIHG PERMIT APPLICATION <br /> Typo of Projett _N�wr_Adtln _A�teraUon_Ropalr Type ol ProJoct: _Now_Addn _AhcraUan__Repair <br /> ShawNumber ofFxtures ShowN�mberryt o7Tutures <br /> AIC—alrhandlin unils Toile[ <br /> ForceOairs stems Bachlub <br /> Ges i in Lavato wash basin <br /> Water hea�r Shower <br /> Gas fire lace K�mhon vnk 8 d;s osal <br /> Gas ra� c Dish�.•ashar <br /> Clolhes d or Clolhes washet <br /> Ran ohood Walerhealer <br /> E��ust fin Sink se.^ricePoar/mo etc. <br /> Heat pump Rackflow revenler inside 61d 1 <br /> � Unit healer Urinal <br /> Boilcr Drinkin Feuntain <br /> Refn erahon Floardrain <br /> Waodsmve Grease 12 <br /> Dua�n Roof drains <br /> Othar Medlcal Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM Other: <br /> Numher of Heads Other <br /> I�emby cenin Via�I liava msJ zn�oumnea uLL:nppiratlm anC Rnow t�e•,amo b Da wo ana eonn;l A�1 pravl;lon.of l�w:a�0 o�d�na�cas goveminp N6 type ol wok rril oo compi <br /> W in afielher sDaOGee hunfn ar nol.7To prenlnA o1 a pamiil 0oa.nut p�usumu lo qho a�NoYry to voqto tt rnnrnl lnu pravNen m any ol�ar ltaln ar L^.uN luw mgo IaUng=p09�utlion <br /> That 1 h� u0o;'a try I�0 aHna�of Nia prnFoly:o pnrtcrm NC vroR(wwfil:h ap0lici]:a�t m:ryc an01 wmpA'��a$la:e Canti97w51,pw 18 27 RGN/antl I90.200A WAC. <br /> , �--- (�-�i -/ S <br /> Ownar/A Hforizod gom5lgnaWre Oate [Revisrc•�rz�r5) <br />