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� <br /> , ` ' PERMIT APPLICATION <br /> BUILD!NG/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERiY 7AIf N P RMIT M O/_ <br /> � U Ffl OC �(C 4�} � �� <br /> LEGAL for new ca+siruction: Slwrt PlaVwbarvision Lot No._ (attaU mpy ot bng legai tlesc�D��on) <br /> OWNER / !';1� � � � .-1 PhoneiE�mad ���x;l - �� � - ���� <br /> aaress - �� � 1 y7 / � 7�i���.�,. cnr�s�a�e�z�o t7/�v1[�� [_:_�`ti y��C� <br /> APPLICANT: Owner OwneY5A9ent ConVador CcnlractolsAgent Tenant�m�+iom„a..be��o•�wKmnom.n.o.+�«ano.,on��n��,a.i <br /> CONTRACTOR c 1 L � F Ct L 8 I Lic.# 0�4t/�7� D.I- COE Bus.Lic.N <br /> Ctl�ess � Ql,�/ Lc��J� ' U.l4C� � lJ'i�4 � 9QY�'� P�one/Email � (�i� ���(� �7 / o/ <br /> TENAN BUSI NA E CONTAC7 FOR pERM1T <br /> 5r� } ���( '�- �.70� 1 �346 _ ..{.�o/ <br /> PhoneiE-ma�l SJ«�Q �{L' CvA7CC.�1•2i�1' <br /> BUILDING PERMIT APPLICATION CONTRAC7 PRICE OF WORK / � <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas�Eiecmc_ otner_ _ <br /> Buildingtype: _Sing�,eFamily ✓Duplez_Townhouse _Multi-Family _Commercial <br /> T ot roeci: New AAdition Remodel Repair T.I. Si n Sprinkler Demolition Change ofUse <br /> DESCRIPTION OF WORK(aadmonal space D��beC on Mo bacA1: <br /> �� <br /> �I�� ��� ��1�5 �' ���ti2GC�-. L�lall�� �.�� <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ot Pra�ect: _Naw_Addn _Alteration_Repair 7ype ol Projact: _New_Addn _Alteration_Repair <br /> SAow NumDer(Nl o!flMres SAow NumDer(1'�)o!lirtures <br /> A/C-air hantllinq units I Toilet <br /> � Forced air s stems I Bathtub <br /> Gas i in Lavato (wash basiiq <br /> Waler heater I Shower <br /> Gas fire lece I Kitchen sink 8 dis osal <br /> Gas ran I Oishwasher <br /> Cbthes d er I Clolhes washer <br /> Ran e hood Water heater <br /> �hausl fan I Sink(service/badmop/etc.) <br /> Heat urn I Backflow prevenler <br /> Unil heater I Urinal <br /> � Boiler I Drinkin Founlain <br /> Refri eralion ! Floor tlrein <br /> Woodstove � Grease trap <br /> Ductin I Roof tlrains <br /> Other � Mediwl Gas <br /> SPRINKLER/SUPPRESSION SYSTEM j Other. <br /> Number of Heatls Other. <br /> I�ere0y ceMy Nat I�ave raW end eiamineJ Inrs a4pU�eton an0 k�ow t�e same lo Oe 1rve and corzed.M pN.iabns al lews anG orEnances Oa�emng Mis ryp<ol wah vMl Lc r.onipl•_� <br /> i <br /> wN�n�eL�eraper/IkB�etenofnotl�eprentu�po� be1mdtloesnotpreSumCtoB��eaW�onrytovi.�lalecrcancelNepmnsionolanyoL�erslaleoilocalltwre9ulaunpmnsvuniw� <br /> l�at 1 qm aul� U!E E�'..T�nrol mn OroneM -0ertorm Ihe wak lor v.firli avC���e��s naae ana I cemnN��c Stare ConVanon L:nv 1 fl 1]9CW d00 396 200T\YnC <br /> ' , j;' ��l <br /> /� i � ��%i ' C.0 �L �� � - <br /> - wixrlA hodzeE Agmt Slgfirture ' nate (Rensed i✓7m7J <br />