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� � <br /> PERMIT APPLICAT�ON <br /> BUILDINGIMECHANICALlPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Evereft, 'NA 98201 425-25'-8810 Fr1X 425-257-8857 vm�w.e�erettwa.�rg <br /> 3 - �( -�( <br /> SITEAODRE55: vpOFenivraxp a�niTn � <br /> � 60 La b ✓ Q_. ootis9l � 100 <br /> LEGAL!or new conswcuon Snon PlaVsubC�v�s�,on Lcl F�o (zltach cepy ot long�egal descnchcn� <br /> OWNER LJ�t� "'� <br /> S e. -e�A r ;.�,�„�,� ,-��� �.0� . 3 � 1 � <br /> �dtlress C,ry/Slale/Lp� Q�� � � I �s` <br /> APPLICANT:�O-.�ner _O+:ner,AyEn� _COdr3Ctcr _ _CCntJCiaf'SAaCnI Tenant��..::,�,.e,..,�,.e��,�i:�.:�,..�rcm�.r>o..-�r��:a,.<..,,�n�-;,��� <br /> CONiRACTOR ;.-:�� , <br /> _,,___ ., Gry eus. GC.x <br /> ACdres, Phane/Ema�.l <br /> TENANT BUSINE55 NAME CONTACT FOR PER�JIIT <br /> PnenNe-na:l <br /> BUILDING PEitM1T AppLIC,ATION CONTRAC7 PRICE OF WORK_�D� . ��_ <br /> Eris�ing Use of 6mltling�'�2C "�C�ra� � HEAT SOURCE� <br /> A � � ( / <br /> PrupoSeC Use��ButlC�.ng-�r ._.�_�j�.SL��`�+- _�'j—�+�1�2,tnQ /r•{p,trq Gas .�Eiectnc�Omer__ <br /> � �--Y}�t� -- <br /> BwiCing type _S�n�le Famdy _Duplex_Towc�.-�;;e ✓(tiluili-Fam�'y � Commerr�at <br /> Tv e of rejecl Ne:� C.Cdihon f2emodei Re a�r 71 S S ` <br /> _ p �n pnn4ler � De�n �hanqe of Use <br /> DESCRIPTIONOFWOR (admre;�als�ac_povitleJonlheeack/� �P 1 � �, (� _ �O � <br /> f�T ` � T �'�L, v <br /> 0.., � V I � � 0..-Y-.�� �" ,� � J,(Z �/ �(�`-�.S � 4,� P � k /�-..� ` V <br /> �-�-��-. rG;,� u S�-�1S -� �� o -.. P_ .��_ � O . <br /> MECHAFlICAL PERM?T APPLICATION PLUM8ING PERMIT APPLICATIOfJ <br /> .�p.. of ProjecC _New_AdOn _Aqeralion_Repair Type ol Projec(: _New __Addn _Alleralion_Repair <br /> Sbaw NumbCr(#)ol lixfurrs Show Number(#)a/lixtures <br /> NC-air hantliin unds Talet <br /> Forczd air s stems Oathtub <br /> Cas �pm lavaio wash basin <br /> � Water hCater 5 . r <br /> Gas fireplace � dr.hen sink&tlis osal <br /> , I Gas ran c . D�sh�vasher <br /> Clolhes tlryer . ^ CIoO��es washer <br /> _ Ran e hootl � � J Waler heater <br /> _ Exha��sl fan _riy _ _ . ^ Sink servicel6arimo /etc. <br /> Heat um _ BackNow revenler <br /> Und hceter .�' Urnal <br /> Ooller '- Drinking Founlain <br /> Rrfri eration ��'' Ficordrain <br /> Woods�ove ,i Grease tra <br /> Dudin l" Root drams <br /> � Other_ _ _ �dedical Gas <br /> L SPRINKLER / SUPPRESSION SYSTEM Other. <br /> � Num6er of Heads I Olher: <br /> I�eret�y cert�.ry I�al I cave rea�anJ e.aTmed rtu:aDP'���ion antl A�o�v If�e sa me ic oe!me an]mrtecl All provisians ol laws an�aralnances govem!ng I�is�pe ol work w.0 Ce wmpl <br /> orAwnelnerspeu5e40ere:nornol tA� rp.ntnqo�apertnd4oe,notpresbmelogr.eaulncrtytouiolateorG]ncellhaFmv�sionolanyalpersla�eorloWllawtegulaLngconslmclion <br /> IDa�iar2au��oneeG�yNemvne�alihr rcnem�lopeiformlhewoM�orxh:;happ'�wucniyrn�Cean�IcnmpMw;di�e5laleCOMra[rorsWw18Y7RCWan�79E1C0AN.'PC �/-� <br /> y"�/lA ` <br /> .��-�1- 3 �r <br /> OwnedAuthorirntl F nl5ignature � �,te (Revised920fJJ <br />