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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SI�NiSPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES �I �-�9�-/Z <br /> 3200 Cedar SL, Everett,WA 98201 425-257-881D FAX•#25-25i-8857 vrvnv.evereftwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITEAODRESS: �FfZf' f./U��" /��;� PGCERl��3Z7Ycjymo P TtJ _ L <br /> ,�, <br /> LEGAL for new con:lmc�ion: Short PI,Vsubdieision _ Lot No._ (���ach coFY o�lonn legal descnp�inn) <br /> OWNER ���i 7 C 'F("�i 5 PhonelE�mail ��L 5 L��� v Lr� <br /> Address � ��L • �76 � � l(b' L, City/Slale�Lip � � -/�L r C .��G� <br /> APPLICANT:_Owner Ov:ner'oAgent ✓=Coniractor Ccnlractor'sAgent _ TenantlR.=:i�rm�'�eea�i�ro�«r:umuomvao�+r��riamw:ra�nmasvawl <br /> CONTRACTOR �C' � � /�� F� < T G� /L&I Lic.# �[e/� ,�J (7� �/'� COE Bus.Lic.#GY7�O <br /> �) � ��d��� Phone/Eraail <br /> AddmSs I i�. �(?�' SS'�� _L�ri�r �� , <br /> TENANT BUSINESS NAME CONT CTFOR PER/MIT <br /> �j/� �U7.lSfJ� yG� c <br /> PhanelE�mail yZ j"-3� �� ! / �C'' <br /> BUILDIN:, PERP!IIT APPLICATION CONTRACT PRICEOF WORK7� - - <br /> Exis�in9 Use of Building F��'>+�- P�� �t' ��-e �`�'itl`� .`' HEAT SOURCF: <br /> Proposed Use o(Building Gas_ Electric__ Oiner__ <br /> Building type: xSingle Famiiy _Duplez_To�vnhouse _Multi-Family _Commercial <br /> TypeofpmjecC __ New __Addition Remodel Repair_T.L_Sign_Sprinkler_Demolition_Change o(Use <br /> DESCRIPTION OF WORK(adtliliona!/space pro��ded on Poe bacMJ: � 1 <br /> �" . �� 7�: c >� �'r..r tc�r%( �fcv�.� r'yJ-L� W� �V'L ,5�c Wc� . <br /> �.. � <br /> MECHANICAL PERMIT APPLICATION PLUMBlNG PEF2MIT APPLICpT10N <br /> Typeo(ProJect: _New_Addn _A��eralion_Rep��r TypeolPro�ect: _New_Addn _A��eration_Repair <br /> Shmv Num6cr(#)a!IiaYures Show Numbcr(n)o!Iixmics <br /> M'C-airhandlingunils ; Toilet <br /> Forced air systems � Bathtub <br /> Gas piping Lavatory pvash basin) <br /> T—Water healer Show^_r <br /> - � Gas freplace Kitchen sink 8 disposal <br /> ��r Gas range Dishwasher <br /> — Cloihes dryer Clothes�vasher <br /> Range hood PJaterhealer <br /> Exhausl(an Sink(service�badmopletc.l <br /> Heal pump Backflo•,v preventer <br /> Unit heater Urinal <br /> ` Boiler Drinking Fountain <br /> Refriyerelion Floordrain <br /> l�'oodstova Grease lrap <br /> Ouctmg Roof drains <br /> I 0t���____ hledical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br />� ( ( Numbe.r of Heads Other: <br /> i r.�r�,by cs�ury ih;tl I havo mad a�d e.amined il�.;e�FF�rcaear�and Fnmv me:::rne lo Go Imo end mrtecl.NI Fmvisions ol la�xs and oN�ances go�eming Ihls rypo e(nroM vntl Co compiied <br /> ;.9����.'i�Iner apenfmtl�ereln or nal.T�v praminB ol a permll tloes�o�pmsuma lo gire aW�onry to�iolale or conccllM10 pmvisim cl any o:hor slala or locai l�w ieBu'at��9 mns W d!on <br /> t i�,:.i I;��n nulhonzeC Oy Ihe ovmcr ol l�b pmpeM�o perlorm��a work hr xTkh app�Kallon le matic and I compli w�h t�a SIY.c CoNraclon Law 1827 RLW end 2'J6100A IVAC. <br /> / 1 '' , <br /> ��� / . ���C�i'�e7 i/ C'�'5����� � ��/���c� G� <br /> ✓V (pPvised 6�7011J <br /> Ov;nerlAuthodzed Agent SlgnaWrc 0 e i <br /> �, <br />