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�ERMIT APPLICATIO� <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLII"ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, 'NA 98201 425-257-8810 FAX 425-257-8857 www.everetriva.org <br /> �{ -a� -I 5 <br /> SITEADDRESS: ��1 � NO/vVG Q� PVPENTYTATOO��/O� O PERMIT# ' � <br /> L <br /> LEGAL lor new conslruction: Short PiaUsu6tlivision Loi No._ (attach eopy ol long iegal descr�pt�on) <br /> OWNER Ql�(�iy S{-�'�O Phone�E-maii 27 '2 3='"�V L��WI�pI: I .� <br /> �tlUress lL-Q Q� P�,.�c City/S�a1e/Zip�V�e�t wa. ��� o3 <br /> APPLICANT: Ovmer __Owner'sAgent _Conlrac�or _CoNractor'sAgenl _TenaNim�sin�o�.aoam�:c�cim�„er•,'�ommeo„�e�iocow�n,vr,,;�r::�� <br /> CONTRACTOR VW 1 Y State Lic.# City Bus Lic # <br /> Address PhonelEmail <br /> CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACr PRICE OF woRK S13I� <br /> Exisling Use of Budding S�. HEAT SOURCE�. <br /> Proposed Use of�uilding C 1�'� Gas_ Eiecuic_ O�her_ <br /> Building type. x Singie Famiiy _Duplex_Townhouse _Multi-Famity _Commercial <br /> Type of projecC Ne�v __Adtlition Remodel __Repair __T.I. __Sign_Sprinkler_Demulition_Change of Use <br /> DESCRIPTION OF WORK(atldRional spaco provided on rhe back): <br /> Ih�S� PRoPQN� 6A5 �R,�•'Pl..�c,� �U u�l�(� RCYI� <br /> �IPiu6 FRO� 2 -1zo G�ct� PF;o�A� Ta�cc�5 �oGP�� �$' FROM Bu�C�. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ype ol Project _New, Addn _Alleration_Repair Type ol Project: _New_Addn _Alteralion_Hepair <br /> Simw Numbrr(H)ol fixtures Show Numbcr(H)o/Oxfwes <br /> A!C—air hanUling unds Todet <br /> forcetl au systems BalhWb <br /> Gas p�ping Lavatory(wash basin) <br /> Watcr healer Shower <br /> Gas tireplace Kilchen sink& disposal <br /> Gas range �ishwashcr <br /> Clolhes tlrycr Clothes washer <br /> Range hood Waier healer _ <br /> Fxhausl fan SinY,�service/badrnoplelc.) <br /> Heat purnp 6ack(Iov+preventer pnstle bltlg) <br /> Und heater Unnal <br /> 6oder Drinking Pountain <br /> Rehigeralion Roor drain <br /> L WoodSMve _ Grease irap <br /> Uuchny ftoof dtains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other. <br /> Number of Heads Other. <br /> I��CreOy cetlily Ip;tl I liave iCatl and examineU Itv;appl�c.�imn entl knoH Ih:same lo bu Irue untl conecl.f II provisions ol laws and oeuinances govermng INs lype ol vvo�k will pa ccmp;i��l <br /> vdn�petlw�•�pec dhr.ttinotnol Thegr:mLnqalapnrmAtlocsnolpresumeloqrve.�ulnontytoviolaleoru�ncellhepmvaionolanyolner,laluoibcallawregulaLngr.onabuci�.un <br /> R�al I�m ni hent�tl h• Ihe o �ne�ol I�is piope�y to prdorm I�e woik lor eih.cfi ap0'icabon is made an�I r,ompiy wtll�Ilie Slata CoMwclois law Itl 27 NCW and 7.96 200A WAG <br /> �J��M_�n�� _ u 2i 2oi�, <br /> OwnntlAuthorired l.gont Siynalurc IJeI� (io,vc:c�l�!/�OIS) <br /> �t'", 2 ._ _ _ ... `�y ,� . rs ,� ., �. <br /> 'a.': , +�x9 iv ,� .��'` �A��v i �` 44 . <br /> � � ,p � ry i'�iy, e�FJS,�t '�•�����\� �, � ,.a� .1`. <br /> .^J�A�t ,iE�. ?� : , . ,7I'*.<., e` ��., ��} ..va..t.rs <br /> � �G'^�� . .p�`'�'�y°'hi . ` ``.A��r6i� kLti�,.,.. »rHt <br /> � .� _w�a.� �_ 5.. <br />