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PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> ApPLICATION9 ARE ACCEPTE�FROM 8 AM TO 4 PM �1$ —I <br /> SITE ADDRESS:. PROPERiY TA%N PERMIT M <br /> 'zOG/ /�C?it/�dl� SZ%'Ict'7" � � ' <br /> LEGAL for new construdion: Short PlaVsubdivision Lot No._ (allach wpy ol lonp leqal desuiption) <br /> OWNER �6 ' '/ �>c^�tSi�6 /it�r1�(1F11 P�one/E-mail /����� '�1� .%2��_ <br /> darese Zd'�/ / C�141f'G� S���C�' Ciry/S1atUZip C��ze�% ua4- 9��/ <br /> APPUCANT:_Owner Owner'sAgeN �omrodor ContractorsAqent Tenantt�«v��••���oi�,mim�mn.w�weao�wn�nm.�o�� <br /> CONTRACTOR �:l.�i� �'/�����% �1G� S %G� L 61 Lic.M/��Jti�'S��Y���- COE Bus.Lic.fIQ lv O <br /> aareg�,�T� L .S�s/i?.f I�'• ,E✓c�k'/l�/J!/ Y6 �� � PhonelEmail �,z5--3��•�7([•,d <br /> q CONTACT FOR PERMIT �,J�yl;l� <br /> ��E'k?�r% %/cL�S:'C�G ,'lwi�yc�l P�one/E•mail ZS=.'03 `i+� <br /> BUILDINGPERMITAPPLICATI9N CONrrtncTPRlceoFwoR � . <br /> Exisling Use of Building �j��l�f� �%s('»/�r� �)-�:�'%L1�� HEAT SOURCE: <br /> R y ' ii <br /> Proposed Use of Building Gas Ekclric Other <br /> Building type: _Single Family _Duplez_Townhause _ ulti•Family _Commerciel <br /> T e ot ro'ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chen e of Use <br /> DESCRIPTION OF WORK(aedirionai space provided ai�ne back): ;���� R��t'<<7��� �� �«!4�'� �/ <br /> C1,2.T��i/ C�t>�z:�1c�?S c`�u�.t� '��f:c� ,rr,1v!c.c/ �L�/c.�r'✓c �^A= i�ctcl->�Y f�y�yt41� <br /> C�,�S /%l.:i� GfSF;j�,:�, .��{�/it�+i�� �i�cx� ,�¢� LL1D r�c:(t}f� ��b�r.�Jl� <br /> MECHANICAL PERMIT APPLICATION PLUMBIN6 PERMIT APPLICATION <br /> TypeofProJact: _New_Addn _Alteratlon_Repalr TypeolProJect: _Naw_Adtln _Alteratlon_Rap�ir <br /> ShowNumber(qollfrturcs ShowNumDar olflxtunt <br /> A!C–air hanElin units Toilet <br /> Forcedairs slems Balhtub <br /> Gas ipin Levato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osel <br /> Gas ran e Dishwasher <br /> Clolhes d er Cbthes washer <br /> Ran e hood Weter healer <br /> Exhaust�an Sink service/barlmopletc. <br /> Heat pump Backtlow neventer <br /> Unit heater Urinal _ <br /> Boiler D�inkin Fountain <br /> Refrigeretion Floor drain <br /> Woodstove Grease tra <br /> Ductin Root draina <br /> Other Medical Gan <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Numbe;of Heads Other. <br /> I hereoy cenM��at I heva rmC antl e�amineE Ihis applkalion enC knmv tho eamo to Co Imo end cortecl.AA provisbm uf 4wa en0 ortlnancef poveminp Ihia rypa of vrork vnl Ce wmDFed <br /> wA0 wfielhe�speufrcC�crein or not.l lia Brantinp o�a permit tloea no�presuma to pive nuthotli/b NOWte or cencel I�o pmNson ui any oNn stete M laal Nw rcpulatHO�onstruction <br /> T�al l nm aWhotlzed Oy Iho ownei al lhla pmpeM�o perlortn tho wod lor w�ic�eppllcetion la v.a0e anC I wmpy wt�Ihe Slate ConVatlon Lew iB37 RCW end Y98200A WAC. <br /> �- %y% tC�iCc� �.t� C.1/3�c'c '/J — <br /> OwnerlAuthdrized Agent Signature Dale (Revised 6/201YJ <br />