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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/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 /> SITE ADDRESS: t PROPERTY TAX q PERMIT Y <br /> '" I L—v� r � � � <br /> LEGAL lor new cons�ruction: Short PlaVsu6division Lot No._ (altach copy of long legal description) <br /> � � Phone/E-mail y J., e c �. — `u <br /> OWNER � • I� � .sr� r)� <br /> Address �3 i � o � . Q� CilylStale/Zip f �j <br /> APPLICANT: Owner _OwnefsA9enl � Conlractor _Conlractor'sA�ent _Tenant�m�sipm�;aeaien�rm�o�se�ummmern.�r.enoaowoa�nmospa�e� <br /> CONTRACTORCi���r�.. C Y /Pa t���n State Lic.#C� r � City dus. Lic.# <br /> Adtlress '�,,� '� ) , �j .S% � 1 u�e/� �C ' PhonelEmail '— � . '� � ) <br /> TENANT BUSINESS NAME � CONTACT FOR PERMIT _ <br /> . 5�'�' S % r»u»S�iv� <br /> �Z� , ���, � )� Phone/E-mail � � i -, <br /> BUILDINGPERMITAPPLICATION coNrRACTPRICEOFwoRK �'r5� c�. <br /> Existing Use of Building ,�p`y A *' � � / . HEAT SOURCE: <br /> Proposed Use o�f Building Ga Eiectric_ Olher_ <br /> Building type: L aingle Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project New Addition Remodel�fiepair T I Sign Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(addrtional space provided on(he back): <br /> (�t ?S i.� (' � '� S l �.,./ �1 ,�S /i r7 ' �t�C/� TPj . t, � � T �V/� �/Z .� <br /> MECHANICAL PER IT PPLICATION PLUMBING P RMIT APPLICATION <br /> Type of ProjucL• _Now_Addn 1'�Alteration• Ropair Typo of Project: _New_Addn _Altoratlon_Repair <br /> Show Nunrber(It)o/(ixfures Show Number(#)o//ixfures <br /> � AIC—air handling unils I Toilet <br /> I Forced air syslems � Balhtub <br /> i Gas piping I Lavatory(wash basin) <br /> I Water heater I Shower <br /> � Gas freplace I Kitchen sink&disposal <br /> � Gas range I �ishwasher <br /> Clothes dryer i Clothes washer <br /> � Range hood � Water heater <br /> � � Exhaust fan ; Sink(service/badmop/elc.) <br /> � Heal pump I Backflo�v preventer <br /> j Jnit heater � Urinal <br /> ! 8oiler Drinking Founlain <br /> ', Refrigeration i Floor drain <br /> ' VJoodslove Grease trap <br /> � Ductin� I Roof drains <br /> ' Other ! Mzdical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> � Numberof Heads ' Olher. <br /> � <br /> I hcreby cen�fy�hat I have re��and examined Ihis app�icafion antl know the same to be true ontl rorred.All pravisions cl la�.vs antl ortlinances goveminn this type ot xcrk v;d�be romFl.e� <br /> v:nh v,nether specilietl herFin or not The 9rantin9 of a permil tloes not presume lo givo amhoriry to violale or cancel l�e provision ol any olher stata or local law regutatin�mns;mcuan <br /> 71��at I am aufhorized by t vmer ol ihis prepetty ic pedorm Ih:work lor wnic�apptiwtion is made and I comply wilh tho State Conirectors Law 1B 27 RCW and 296100A N.�AC. <br /> r : <br /> Ow� '� ` � l� ��� <br /> ul or zod Age t Signature —��'' ' �ate (4evimd 3:2073) <br />