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� � <br /> PERMIT APPLICATION <br /> BUlLDING/MECHANICAL/PLUh9BING/SIGNlSPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St.. Everett, WA 98201 425-257-8810 FAX 425-257-8857 evww.everettwa,org <br /> 6 -as�� <br /> SITE ADDRESS: / 0� f � ` PROPERTY TA};ry PE MIT� ,O YO � <br /> /o� 4�� �v� t./' <br /> LEGAL��r new conslruclion� Short PlaVse6division Lol No. (allach copy of long legal tlescnr�.�,on) <br /> OWNER /V � i `'�/ PhonelE-mail a(j �7 �6 y "r�—�7, O <br /> Address / O�_ /O 1^� F�/ a vL CitylS�alelZip � �/t,f L✓/r �p O�-U� <br /> APPLICANT:�O�vner _Owner'sAgen� _Contractor _Coniracior'sA9en1 TenantU��,�.ic:o�.co,�m•��rawr�se.,�ocm�noo�..�ror.oeo���o:x��n��sc��o� <br /> CONTRACTOR �1 o+�c O���f Slate Lic. # City Bus. Lic.# <br /> �ddress Phonel[mail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PlionelE�ma�l <br /> BUILDING PERMIT APPLlCATIOYJ CONTRACT PRICE OF WORK �� <br /> [xisting Use of Butldmg_ HEAT SOURCE: <br /> Proposed Use of Building Gas x Electnc_ oiher_ <br /> Bwlding type. ,�Sirgle Family _Duplex_Townhruse _Multi-family _Commercial <br /> Ty�e o(n�eject Mew Addilion Remodel _ Repair__ _TJ _ Sign_Sprinkler.__Demolition _Chang= ol Us� <br /> DESC RIPTION OF WORK(addrtiona�spr.ce provided on me back��. <br /> outdar /��54 - �vtT�,,/ Uss - G�;�� � i' o�� � l.�< <,�,/ <br /> �,,h � � � r o••ra.✓�' <br /> ,NECHANIi�AL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Pi :�ect: _Ne�v_AUdn _Afleralion__Repafr Type of Projecl: _ Nev+_Adtln _Alteration __Repair <br /> Shmv Ilum6c�(dJ o/lixfures Show Numbcr(#)o(IirNres <br /> NC—air handling unils I Toilel <br /> � forced air systems I Balhtu6 <br /> � Gas plpin9 I Lavatory(wash basin) <br /> � Water hea�cr � Showe� <br /> Gas freplace _ � Kdchen sink &disposal <br /> Gas range � Dishwnsher <br /> � Glothes dryer � Clothes washer <br /> � Range hood Water healer <br /> � Ezhaust fan I Sink(servicelbadmop/eta) <br /> � Heal pump I Backflow preventer <br /> � Unit hcater � Uiinal <br /> � f3oJe.r Drinking Fountain <br /> � Re(rigeralion � I-1oor drain <br /> � Waodslove Grease Irap _ <br /> Dudin9 _ � Roo(drains <br /> � Other � Medical Gas <br /> SPRINKLEIR I SUPPRESSION SYSTEM � otlier <br /> � <br /> Number o(lieads i Other <br /> IhaebycciLly:hallhmuieafantle+amincdlhi;:ip^,hca�?nandYnovilne;amclobeLueandcoirccl N'�Provision,olfa�rsantlorEinance;9overninglhislypeolwmkwill�cri�mplerl <br /> ;nni nhelhe�speafieC�erein nr ncl i�e 9�nnting ol�pumA tlo�:nol prewme l0 9rve au��honly lo viol,ile or cancel lbe provr.ion ol any olhe�s�ate o�lou�l law regulatin9 comdm�ii:�� <br /> ❑nit I am avihonrrtl by i�e ov�ner ol iN;pwpeity lo pedorm Uic wn.k lo�ai�¢�appfcalion Is matic aa01 wmply vnih ihc Slale Conlraclois law 10 77 RCW anE 7962GOA N'AG <br /> � _ ,�-Tit 4'a �"S-�/1 <br /> Owncr/Aulhorized/lgmit Slgnature Dale (ReviscA t/:017J <br />