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G:5-252-166h CV1HEAiING �16�ABarr 0?-02-TO'S ? /3 <br /> • <br /> PERMIT APPLICATION <br /> BUILDING/II�IECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Gverett, WA 98201 425-257-BB10 FAX 425-257-8857 �wnv.everettwa.org <br /> a - � -� 5 <br /> SITEADDRESS: PROPERT"TA%H PE �71T <br /> rvn�� C�uc. �,- Z <br /> LEGAL lor now construnlon: Shon PlaUsuhdlvl,ian Lct No._ (allach ropy o!lon;�Icgal tic;u:Vlior.) <br /> OWNER �� L 5 PhcnNE�mall y2� � p�tpQ <br /> Adtliese �,,,Y�� ad GilylS�ale2ip <br /> APPLICl1NT:_Gwnr.r _Oxno�sl.penl �Conimclor __Ccnlraeto�'.Agent _7enanl��ysicz.:�on,orurnc�«�iimmv,ov.*:e�n::w:+.nmoe;,ace� <br /> � /�� <br /> CONTRACTOR Q, � nL S!ateLic.RU�1 Z:�`0 5� CdyBus. Uc. #�1�� <br /> Aa0rc,5 �"p ��� W�" qg�Q' Phane/Email �� 25 ��� <br /> TENANT BUSINESS NAME CONTACT �OR PERh71T <br /> ��,t�jbl,e, '�25 25Q ln b(��. <br /> P onclE mail ,(f)F'V� <br /> BUILDING PERMIT APPL[CATION coNTRAc7 PRICE oF WORK��D� <br /> Existing Use at Bulld'�ng HEAT SOURCE�. <br /> Praposed Use of Building Ga; Elecl"c Olr,er <br /> �uilding type: .L Single Family _Duplex_Tawnhouse _Muili-Family _Commercial <br /> T pe al ro'ecf New Addition Remodel Re air TJ. Si n S�dnkler �emcliticn Chan e of Use <br /> DESCRIPTION OFWORK(otlCdionalspu�uplcv:tlodon�hoh ck� <br /> P�.�l.ar� �i s�i n9 �a s �fu rx.a.csz- �- h.et w a�, -f-a.+Ll< <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLIGATION <br /> Typo of PraJoch _Now_Addn _Allora(lon_Hupalr Typo ol ProJoc(: _Now_Atltln _Aitamtlon_Rapolr <br /> ShowNumbor U alllrturvs ShawNumbcr fl o/!!z}urvs <br /> A/C-alr hanalir, units Tollet <br /> Forcetl air s slems - Balhtub <br /> Gas I In Lavalnr wa,h�asin <br /> Water heaier Sho�.vor <br /> Ga, fire lace Ki�chen sink 8 disposal <br /> Gas ran e pishwa,hcr <br /> Clolhes drver Clclhes wasl:cr <br /> Ron e hood Waler heater <br /> Exhausl 1�in Sink 3ervicclbar/mo ilctc <br /> li�at urt� Backllo�.v revenlnr <br /> Unil hcalcr Utinal <br /> Boller Orinklnq Founlaln <br /> Refri craticn Floo�dr�ln <br /> Woodstovc Grease Ira <br /> Iluclln Roof drains <br /> Olher_ Medical Gas <br /> SPRIPIKLER I SUPPRESSION SYSTEM Ofher: <br /> Number of Heods Other <br /> 1 hmeOY�eiWy Ihul I�ow moa nnG o.omined Iha uppLeilian ontl Anvw 1��auma to bo Irvo on��qncU.All pmvis�on�cl lows antl eNinancep gavo2lnp�p's�ype el v:aik n'I ba cemp' <br /> �u�q w�eNur�peu'ed hertia nr not.tho pion�np ef o peemit Eoo.nol prosvmu lo pivo ouNo�ry�v viololu ar eancel lho pmNsian ol any athoi slaro ar Iorai low m9u:ai�ng wn:tron�on <br /> Thal I am uul�eriintl Oy Iho mnnar ol I�Is p�openy lo pedoim lho xmk fcr wMJi oOD��cnLon Is meGu anE I rompiy w�lh tho Siolo Conlrnnc�s ln�w 19 77 RCW entl 190.200A WAL. <br /> —�.� �auuuc 3.a•I �- <br /> Ownar;�Iuthod:odApont pnaluro Dalo ;r.avise09/10;4� <br /> (/ <br />