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PERMIT APPLiCATION <br /> BUILDINGIiVIECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITIO�I <br /> CITY OF EVERETT PERMIT SERVICtS <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everetiwa.org/ 7 <br /> APPLICAT!ONS ARE ACCEPTED FROM B AM TO 4 PM I ' V �r u <br /> SITEAODRESS: PftOPERNTA%p -R #� � <br /> iva �a ,— �� <br />` LEGf L for new consimction', Shotl PlaVsubdivision____ Lol No._ (altach wFp ol icng Iegal tlesception) <br /> OWNER �� i � Phon=/E�mail t��`� " y Z z � �'yC 3 <br /> nS <br /> Atldiess �-f��� ��JyT !)v� Cay/StatelZ�p �vG�e/� ��� <br /> APPLICANT:_Own•r Owner's�genl �,Comracter Coniraclor'sAgenl TenantlT�-:�mmaoa�e��mcome�.itto�nm.e�-..�:noa�«oa�nmo:�ace1 <br /> CONTRACTOR C/aMI� P-Il5 , ���r7 �/�C L&I Lic.# 17M COE Bus.Lic.» <br /> ��/��n?lS ��' o�C�C�� Phone/Email /�s 'a S)' ^, � <br /> Address /,Z�/ C✓ CONTACT FOR PERMIT <br /> TENANT 8l1SINE55 NAME <br /> PhonziE�mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICC OF WORK <br /> Exisling Use ot Building HEAT SOURCE: <br /> Pwposed Use o�Lilding Gas__ eieanc_ Omer_ <br /> �uilding type: Single Family _ _Duplex_Townhouse �(HWti-Family _Commercial <br /> Type of pmjecC �`New _Addilioi� ^�_Remodel _Renair_TJ._Sign_Sprinkler_Demol�tion__Change of Use <br /> DESCRIPTION OF WORK(addi(ional space proNdea on Me b,ac�): <br /> ���tl ���.��C,� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol PrqecC _Ncw_Addn _Alleratlon_Repair Type ot ProJecl: _Nmv_Addn _Alteration_Repalr <br /> Shmv Nmnber(NJ of lixlures Show Nurnber(k)o/li.rtuics <br /> A/C—airhandlin9unrts I Toilet _ <br /> � Forced air sys�ems I Balhtub <br /> Gas piping I lavato (wash basin) <br /> Water heater i Shuv:er <br /> Gas fireplace I Kdchen sink&disposal <br /> Gas ranae � Dishwasher <br /> i Clothes dryer Clothes washer <br /> � Range hood Water heater <br /> Exhausl fan Sink(service/badmopletc.) <br /> Heat pump I Backflow prevenler <br /> Uni�heater Urinal <br /> Boiler Drinking Founlain <br /> Refrigeraiion Floor drain <br /> � Woodstove � Grease trap <br /> � Ducting Roof drains <br /> � ���1ef Rledical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Omer. <br /> Number of Heads � Olher. <br /> IP i_bycei y11.atllineerccJu tlexann�f If �p���.a:ion,i�dknuw�h^samelo0elrueanticoneci A'Ipmnsln�.sollmvaondo�dinancetBovemm9lh'styFeclreheil�oco�r;IcJ <br /> �.., �:hclusV=�''�etlherenornal.Thop�min0ot�penn:ldoosnolprenr^_tog'�eaut�antylnvolaleorcanccllhoprovlslonolanyol�e�51n1eo�Ioceltrirr�ubYpcerslrcU.rn <br /> i hnl I am amlio�imd by Iho owncr ol ihis propchy lo ocilonn�in rmrN lur wt�i<�acpacation ie ma0e ane I compry e:l�t�c Stato Conlraclora Low 18.77 RC W ard LE�i.COA Y:9�C. <br /> OvrnedAu�hoNzed Agenl Signalurr Uale (Rer':�tl 6/20tt) <br />