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� � <br /> PERMIT APPLICATIOf� <br /> BUILDING/MECHANICALIPLUMBING/SIGNlSPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, WA 98201 425-257-P810 FAX 425-257-8857 �v�^n•�everettvda.org <br /> SITEAPODRES : C � O PROPERiYTAxp PERf��T� �—D� � ( <br /> � (� •'i <br /> LEGAL for ne+i conSUuclron Shorl PlaUsuCtlivis�on LoI No._ (allach copy of�ong legal descnpl�on) <br /> O'NNER� J1"e-- � �eA-� 'J� I lll�-LI PhonelE-mail ��ap�"' �� /" ��J'� <br /> aaa:oss,3 yU N�l�"�"�^'�? � (� C�iWs�a�erz�� �uer-� . w f� � �� <br /> APPUCANT:_Owner Ovrne�'sA9ent xCon!iaclor _Can�ractor'sA9ent 7enanl�n,siP„�ou.,i��•er�c-�.e�n�r,mon.��ermao�Nc:.,�ease+--1 <br /> CONTRACTOR �� 1 � t� ��51 LJ State lir.. �FIJLGS � Ciry Bus Lic.# <br /> Adn:ess p� j�� 1/lT�— Y.e !'�Lli1 �pW Pnone�[maA uZ5 -33o-S�-169 <br /> TENANT BUSINESS NAI'nE �QNTACT F0�2 PERMIT <br /> ,��,_ I�1°��-•J <br /> ,�s���� <br /> P�one�e'-ma�l <br /> BUILDINGFERMITlSPPLICATION CONTRACTPRICEOFWORK <br /> �Aistina Use of�udding HEAT SOURCE� <br /> P�000sed Use of BwlCin� Gas__ Gectnc__ Ciher _ <br /> ewltlmg type _Smg!e Famdy _Dupiex_To:vnhousz _tv1Wli.Fam�ly _Ccmmeraal <br /> Type ol pro�ect L'e�,v Addill�n Remotlel Repair_ T I _S�gn_Sprmkler_Demohbon Charge of Use <br /> DESCRIPTION OF WORK lzed r on=�spacc pm:dev en ihc naca) <br /> (`�'�- '�v� I /�LS'�-�` �D�''1^'P e.i f w��' w/ L7 tSC a til�lr�--'� <br /> i <br /> MECHANICAL PFRMIT APPLtCATION PLUMBING PERMIT APPLICATION <br /> Type of Pwject: _New_Addn _Alleration_Repair Type ol ProjecC _New_Adtln _Alleration_Repair <br /> Show Ilumbcr(al ol7ixfures Sbow 7lumGer(N)allii(ures <br /> AIC-air handling unds I Todet <br /> I Forced air systems I Balhlub <br /> j Gas pipin9 Lavatory(wash basin) <br /> Water heater � Shower <br /> Gas Oreplace I K�tchen sLik 8 disposal <br /> � Gasrangc Dishwashcr _ <br /> I Clothes drycr � Clothes washer <br /> � Range hootl � Water I�eoter <br /> � Exhaust lan I Smk(scrvice/6admoplMc) <br /> � Heat pump I dackfow preventer <br /> � Uml heater I Unnal <br /> � �oticr Dnnkmg Fountam <br /> � Relrigera!,on � Floor drain <br /> I Woodstove I Grease trap - <br /> Ducting �—�--��-�— I Roof drains <br /> � Olher__(7-�1_�✓c-/ � Medical Gas <br /> SPRINKLER / SUPPRES510N SYSTEM � Other <br /> I Num6er of Heads j Olher. <br /> i nere^_y cenAy inai I na�.e read antl z.amined i�is apG�'�cauan anC kno�v thu same io�e Ime and mned Ail pmv�s ens oi la:;s and mchnances govern�ng mis type al work xri be ccm��:d <br /> ;,�R�v.nel�er spec Ge�Y�erein cr nol.T��e granhng ol d perm�.l Ooez net Fresum_lo grve a�lhevP/lo vio'ale cr caccel I�e p:owsmn ol any Uher 9a1:or 4^cal�a.v regubPng co�sfrvcbce <br /> inn l ar ^uIDenze4 Ey��.e omnei c1 in�s preCerly�a perto�m ine�roik lor vinicb app.'.w6on is ma:^a��C i cemG-Y r^:�in�51aie Ccmio::o,La.v 19.P FCV;::�a 255 2(Ca V.'�C. <br /> ����`� �� I/ ''� Revacd3R013 <br /> Owner/Authorizetl Agent Sig�atur �ale � � <br />