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� � <br /> PERMIT AF'PLICATION <br /> BUILDING/MECNANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , Everet?, 'NA 98201 425-257-8810 FAX 425-257-8857 v�w�v everettvea org <br /> SITEADDRESS: FROVER7VTA%n PERhLTq ' O�� <br /> ljill S keh waad p� Lo�,e�f <br /> LEGAL lor nc.�con;lruchan Snort PlavsuCdn�ivon Lct No (atiach capy oi�ong�ega!Ocscr¢bun) <br /> OWNER nQ Pil� I �' �/) �'noneir-ma�i ' <br /> ned�ess Ciry�StateiZip <br /> APPLICANT:_Cwne� _Ov�eers�geni �(_Cenhacter _Contracto'sPgenl _TeeaNfm-;�c�=,-��.•�ie�c�c.-:c-n�o-�a��..����:oto._�. -i^.�.:.,-.�i <br /> CONTRACTOR �'.� br�� �� 1 :. � „ State L�c # < <+n� Q b p �k �h- 5 Cny Bus L�c +i <br /> a���esti a'7 . �7.� A S.5 �'1 1 C vii.'f'f wAq S3 7 o G Wr�oner[ma.� N LS ZS 5 �j `� �i`3' <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Pho�.._�;-ma�l <br /> BUILDING PERMGT APPLICATION coNTRnCT aRice oF woRrc._ _ <br /> Fxislirg Use o'6ul�lrg__ __ HEAT SOURC[ <br /> Pro:os�ed Use cf Bwic;ng__ _ Gas__ Eiectnc�'_ Otner_ <br /> Hw!tl�ng type _Single Family �Duplez_Townhouse _W�Iti�Family _Commerc�yl <br /> TyGe of prc�ect Nev. Atld�l�on Rumotlel _}[. Rzpar__T I Sign Sp�inkler___DenollUon_ChanGe of Use <br /> DESCRIPTIONOFWORK !ad^r�onaispa<ep�c:,cevc�rrobac-i �eP�v�' $v 5e ���� No� ws>•� f'�^r <br /> MEh:HANICAL PERM{T APPLICATiON PLUMBING PERMIT APPLICATIqN <br /> Typo of Pro�ecC _New_Atldn _Alteralion�Repatr Type oi Projecl: _Nrw_Atldn _AlteraUon .Y Rep�ir <br /> Show Number(aJ o/!ir(ures Show Numbcr(p)ol lirfines <br /> � NC -a�r hantlhng unds io��ie� <br /> I forced air syslems [3alhtub <br /> Gas pip�ng Lavatory (wash basin) <br /> Waler heater I Shower <br /> Gas Greplace I Krtchen s�nk 3 disposal <br /> Gas range i Dishwasncr <br /> I Cla�hes drycr I Clothes e:asher <br /> Range hood <br /> Exhaust fan Smk (scrv�ceibar/mop�Mt) <br /> � Heal pump � I3ackllow preveNer <br /> � Und hcater Urinal <br /> I l3oiier I Dnnking Founla�n <br /> i Refr�geraUon I Floor tlrain <br /> Wootlsto�e I Grease trep <br /> � Dudmg i Roof drains <br /> j Other__ __ I Metlical Gas <br /> $PRINKLER I SUPPRESSION SYSTEM ! Omer <br /> Numher of Heads I Other. <br /> I tlCa�y ceflAy ihal(�Jvc reStl an9 e.am re01Ms app!caLen a�itl�rca:t�e;dmC 1p[e Ime and Wf�Cd FII promsions ol laws A�tl arU:n.lnee5 9o�R�mn��Pis lypa ol wert n '�b:rr.mf'e� <br /> r:^�,�bel�eispen9ed�ere:norrcl t�egranWgolaci�m9Uoe;rclp•esum,erogseaoiMnlylovioialeoreancelt�oprcvisionclanyclnerstaleo�lowllawregulaingce�:'��,C�ri <br /> lPdl:am aul�enie0 pY I�e on��^l cl�I'�is proP��ty lo petlOtm I�e wC�h 10��+P�c�a{;'-cdPon i5 n�aC¢anC i c.^mp;y Hf�I�v-Sla'e Ccnhac:ors W w iB Z7 RCl'!a�tl 756 200A l":4�.: <br /> �� � Y-i� -i4 <br /> �utharized Agent Slgnalure Uale (Revrsed 3�.Gt?) <br />