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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBlNGISIGNISPRINKLER/DEMOLITiO�I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.eversettwi.4rgy I <br /> PROPERTYTA%N PERMIT# O' <br /> SITE AD 02 �i <br /> LEGAL(or new constmclion: Short PlaVsubdivision Lot No._ (altach copy of long legal descriplion) <br /> � PhonelE-mail ,(,7� /23" � <br /> OWNER� Ll tIq Q"�(� <br /> Address vZ Ciry/Stale2ip W� � `--" � <br /> qpPLICANT:_.Owner O�sner'sAgenl _Contraclor�CONrar,tor'sAgenl _lenantlm�:�p�oY�eoemner�rc��somncmmawrnenaao.�o��nmospa�ol <br /> " � L � Sta�e Lic.# $� s tl2.� City Bus. Lic.�t <br /> CONTRACTOR�� n r^6 65�/ <br /> ^ 1 �J� !'� !'. . L1�1. � ��y�p Phone/[mail 20G•7 L Y <br /> Adtlress J-1 > >;q'�'��'i' <br /> CONTACT FORjER�_ �IT . r �5 <br /> TENANT BUSINESS NAME �^_ y}-�,��� <br /> ��-..c.vt/� d <br /> PhonelE-mail • ^7 �� — 6�� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I S `E�� <br /> � ,l HEAT SOURCE: <br /> Existing Use of Building <br /> Gds_ Eleclric_ Other__ <br /> Proposed Use of Building <br /> Building type:�ingle Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of p�oject�. New _Addition _P.emodel _Repair_T.I._Sign_Spri� '�r�1���6�t ange of Use <br /> DESCRIPTION OF WORK(additiona�space provided or the backl: S <br /> z�.� �. ����.s� �►�. s���.�� p <br /> MECHANICAL PERMIT APPLICATION PLUMBENG PERMIT APPLICATiON <br /> T o of Pro oct: _Now_Addn ._Altoration_Repalr <br /> Typc oi Project: _New_Addn _Allcratlan_Ropair YP ' Show Number(#)o/fixtures <br /> Show Number(N)ollixtures � Toilel . <br /> � A/C-air handiing units � BatMub <br /> i Forced air syslems � Lavalory(wash basin) <br /> � Gas piping � Sho�.ver <br /> _ � Water heater � Kitchen sink&dispcsal <br /> Gas freplace � Dishwasher <br /> j Gas range C!othes washer <br /> �, Clolhes dryer � <br /> ! Water hea�er <br /> i, Range hood Sink(service/bar/mop/etc.) <br /> Exhaust fan � <br /> i � Backflow prevenler <br /> � Neat pump � Urinal <br /> j Unil heater � <br /> Boiter i Drinking Fountain <br /> Refrigera�ion i Floor drain <br /> Woodstove I Grease trap <br /> Ducting I Roof drains <br /> �� Other__ � Medical Gas <br /> SPRINS(LER / SUPPRESSION SYSTEM Other: <br /> Nurnber of Heads <br /> Other: <br /> I nereby certAy��al I have reatl antl examined ihis applicalion and knowlhe same to be Irue and correct.FII pm+isions of laws and ordinances goveming thic type of work vnll Ce complied <br /> Thm I m'aWhonzc9 byhl�a tn ner of 1 hs proDeltly to peAo m tha xorklfo�whkh ap01 catioo s matle alnd'I mmpty wrth the Slate Convadors Law 1'827IRCW antl 256200A Wq��tion I <br /> 1 � <br /> �` � � � (Revised3/2073) <br /> n r Authonze A ect Signaturo Date <br />