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• . <br /> PERMIT APf'LICATION <br /> BUILDING/MECH�aNICALIPLUMBING/SIGN/SPRINK�.ERIDEMOLITIOlV <br /> CI i Y OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, VVA 98201 425-257-8810 FAX 425-257-8857 www everettv+a.urg <br /> SITEADDRESS: �� PR07ERTYTA%N PERMIT: � <br /> Qo�o Na �r � - <br /> LEGAL lor nnvi censtrucborc Shon Piausuhtl�visien Let No._ (attac�copy o�long ie9al descrrol�on) <br /> OWNER �YONNt rJ/��fV �� Phone/E�mail L' 2 S" 7(p�i OJ J / �:� <br /> A��«5, o � c.c. �J�2 3 � ��,Y,S����,Z�p � <br /> x <br /> APPLICANT:_Ormer Cwner'sFgent ,[�Cantractor _Co�lractor'SAgen1 Tenantlmosi,�o.�,eoo�ererc�«nse.,n�c.,,e�c.�•;�ueowaa-.i.�wspa:cl <br /> CONTRACTOR ��—C�.��,�1 / ���'VJ�� StateLic. # � �A� (�����tyBus Lic k ��;� <br /> :,�'dress � �4� �A71yV`(.YIL -�j �SD N � � Phone/Email J� Q � � �.J^��^� �� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT � 6 � _l` ����J` <br /> �,q / � 7 3 <br /> Pi�onelc-m:ul � �� ��`��+��-� <br /> BUILDING PEItMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exishng Use ol Bwlding �A=S��_ HEAT SOURCL. <br /> Praposed Use of Bwld�ng__ _ Gas__ eiectnc_ omer_ <br /> 6uilding type _ Single Famity __Duplex_Towuhouse _Multi-Family _Commercial <br /> Type of pro�ect Ne�v Atldition Remodel Repair_T I __ Sian_._SpnnY,ler.__Demohtion__Change of Use <br /> DESCRIPTIONOFWORK �ar,dinona�spacep.ov�dedonmebacW ^ �'C <br /> /2�(' lf� Cc �X1.���� C�J /J���-'�2 � <br /> �> fr9�'7E ?�r/J7�°n/ <br /> MECHANICAL PERMIT APPLICATION PLUtVIBING PERMIT APPLICATION <br /> Typo ot Project: _Nuw_Addn _Alteration_Repair Typo of Project: _New_Addn _Alteration_Repair <br /> Shmv Numbrr(N)o//ixtums Show Numocr(p)o!IixNrrs <br /> NC-av handhng units Todel <br /> Porced air sysfems Oathlub <br /> Gas pipiny Lavatory(wash basin) <br /> I Water heater Shower <br /> Gas f�replace Kdchen sink 6 tlisposal <br /> Gas range Dishwasher <br /> I Clothes dryer � Clolhes washer <br /> Ran9e hood Water heater <br /> Exhaus�lan � Sink(serv!ce/badmopletc) <br /> � Heat pump BackOow prevenler <br /> � Un�l heater Urinal <br /> � Botler Drinking Foun�am <br /> Rehigeralion Floor drain <br /> � Woodstove Grease�rap <br /> Duclmg Roof dreins <br /> Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM � Otner <br /> Number of Heads � O�her <br /> I�ereEy ceN!y t�al I nave reaa anU examinea�Ois appSca�ion an0 kno�v Ihe samo to be Ime ana cortecl.All pmvisions ol laws an0 orEinances 9overmn9lnis type el wa�k wll be comp'ied <br /> vnl�whe�her,peUfietl Aeren or nol TM1e granim9 0l a perm� no�FMsumo to give a���only lo vlo�ale or w�cel l�e provision el any ol�er state or lowl law regulabn�cansVuct��on <br /> Tn�t I am aul�orized Oy Ine � er ot I�is Freperty lo pe rtn��e w k lor w�icM1 apD��wbon,maCe a�C I cemply�vA�Ilm Sldle Conlractors W w IB 2%RC W an0 256 iOCA N'AC. <br /> 1 e �..✓�l r _'_� <br /> ( i'i ,'.nth'-ii ptl.tq��n($n1a�Lun• f�.d � ...� �-'�' . <br /> _. ._-_ .__ ' . _'_"__..... <br /> . _ � ,, v.. ,. .,rN'a a-.+... .y,� ��..:� q.y.. ,..., , �gM#'6`�';y.�dfiy,°��°�sr°> n�� . .w,t-w.Wr <br /> �16. :. .-� ..:ee.�"i'{16i{> �4'�'�..�, .... �_:txei Y.Lc-tl,'.�A'�'^� � �. .: ' � <br />