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� <br /> � <br /> PER'MIT APPLICATION <br /> B�1ILDINGIMECHANICALIPLUMBINGISIGNISPR�NKLERIDEMOLITION <br /> � CITY CF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 42�-25�'885� `"'^^^'everettwa.or9 2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM P�iT% —O I <br /> PROPERTY TN(M <br /> SRE ADORESS:��� ' ^�C� � — <br /> C.J7 <br /> LEGALfornewwnsWction� ShortPlaUsuM�rvision <br /> Lot No.__ (attaU coPY of long legal tlesaiP�on) <br /> �n �I �J•�Q,el i 7 PhonrJE-mail LI�S3C1,�II�J � <br /> OWNER FIJ.V�–F✓�T tJtJI�J/�G c�ty�s�«P _ �/.��� � �/ <br /> . Addra:s �7/J 1�� V <br /> APPLICANT:_Ovmer _OwnersAgent �p�ntraclar _ContraclorsA9ent _Tenantimuno�eeknaamnsnx�omme^Y"'e'e°°"°'°^mascxal <br /> 2scr$Tf'j/YlS !/JCL&ILic.# W��� S/'2 COEBus.Lic.#Q� <br /> CONTRACTOR�CD a� p���mail �d 64$G�G <br /> Addreu_7ID..S�7�7r�i -�' 9$�� CONTACTFORPERMIT <br /> TENANT BUSINES NAME �� 648�26 <br /> PhoneJE-mail /^x �T <br /> CONTRACT PRICE OF WORK � <br /> � � C�CJ <br /> BUIL6ING PERMIT APPLICATION HEq7 SouRCE: <br /> Ex�stingUseofBuilding �KC�✓Y^/1/�7/01 — <br /> �Gr�✓1i=.,l.il�f _ Gas Electric_ Other_ <br /> Proposed Use of Building Commercial <br /> Building l�pe: _Single Family ,�Duplez_Townhouse _MultrFamily _ <br /> S rinkler Demolition Chan e of Use <br /> T e of ro'ect: New Addilion Remodel Re�air T.I. Si n P <br /> � o2SSoS'6.5$�" <br /> � DESCRI���� �(�/9��^a�JG'���back): � 7/\'ti"= i'f,�.L�l <br /> I W�G .�1� <br /> . �d�r ��/7�C�S� <br /> MECNANICAL PERMIT APPLICATION <br /> pLUMBING PERMIT APPLICATION <br /> TypeolPro�ect: _New_Addn _Aiteration_Repair TYPeotProJect: _New_Ad�n ,_Alteration_Repair <br /> Show Number(M)o/�xtures <br /> ShowNumber(Mlo�flxtures � Toilel <br /> � AIC–airhandlin units gathWb <br /> � Forced air s slems �avaW (wash basin) <br /> � Gas pipin Shower <br /> Water hecler � Kitchen sink&disposal _ <br /> � Gas fire lace � Dishwasher <br />� � Gasran e � C�otheswasher <br /> � Clothes d er Waler h=aler <br /> � Ran e hood i Sink(servicelbadmo lela) <br /> � Exhaust fan BackFlow reventer <br /> � Heat ump Urinal <br /> � Unit heater Drinki Fountain <br /> � goiler � Floor drain <br /> � Refri eration � Grease lra <br /> � Woodslove Roof dreins <br /> � Ductin � Medical Gas <br /> � Other�— Olher. <br /> SPRINKLER I Sl1PPRESSION SYSTEM p�her. <br /> � Number of Heads <br /> al xark w�Ue comDlied <br /> uWGn .wnstiuclbn <br /> � I hereby ceMy��at I have read an0 examned this apP���bn anA knawtho same lo�o Vue anG mrtect.AO P�°°'�1O^s ol Wws anE ortlinances gavemmg�M1is�YVa <br /> vn1�wnelner cpecifieE neroin or no!.T�e grd^��910��o�Me work IorewMM app'Iicaflon i�s matlo and I comPN���1e S���contraaors�aw t'e 27 Rcw n0�����Aw'��' OD <br /> Tl�at I utno�izeA 6 e ei+��� P� P / �/S �� <br /> �v <br /> � –�� ��� (RevisedN2012) <br /> Owned uthorized Agent Signature <br /> Date <br />