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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF FVERETT 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 /> 51'EADDRESS: � PROPERNTA%p PERMITM <br /> i / Ci>9L "%c/C � � ri// riT �C� . IL - 35 <br /> LEGAL br new construction�. ShoM1 PlaVsu�Oivision Lot No._ (allach copy ol long legal descripiion) <br /> OWNER �(/(/��f// /-�C�t.y;JL ��-c7NJR.�-?�� Phone/E-mail �� /1 y n�'� � <br /> dCress /Q L(��p /y L", City/SlalelZiP L'(��i(�L'/� L!J/�� lnv� <br /> APPLICANT;_Onner OHnefsPgent Conlractor ConlmcloYSA9en1 _7enant(m�nc�.A�•�n•�o�wn+emnomr.a�.�erweo+.on�nn.,wu1 <br /> CONTRACTOR . .�� L�i+1LCAr�A/i� S rG�6��'� L&1 Lic.#��f�1�1� S/ yQL' COE 8us.Lic.# / O <br /> Adaress ��(,Yp ..$/1)F!1/ (�L'. �" � r' L(�� . PhonelEmail �y - ��3-giGv <br /> E A T USIN SS NAM CONTACT FOR PERMIT �;Q��, m.9y.��',�D - <br /> LUL�C��/L�L�l.J ��K/r P�one/E.mall���v�-�r�� <br /> BUILDINGPERMITAPPLICATION CONTRACTPRICEOFWORK D ,D �/� 'u/. <br /> Exisling Use of Building �SG/ad[J�7%� L�B�'��h� _ HEAT SOURCE: <br /> Proposed Use of Bu��ding ����7e h� e Gas �ecinc Ot�er <br /> Building type: _�S/ir1g@ Family _Duplez_Townhouse _ ult6Family _Commarcial <br /> T peof pro'ecC l� New _Addition Rernodel Re air .I. Si n Sprinkler DemoliPon Chan e olUse <br /> DESCRIPTION OF WORK(aoeiriona�spareproiidedonmeeacxl: �(��' _ /✓�Qf�Y! t/ 2G)/,3-(.7/ �jCi?ItJC��' <br /> C�l�r���lCi� C�c,:�i�n1G, Q (k%e�i�i/� G/JS h�/dN.4� TUS/'1�'/ iUe�lJ G'/�St�o(�iU9C�=� <br /> C «s��,�rc:z ��y��c..�,J r,,la<<s,L�- a� r�� /vr/ouJ�iUb .�7'�iY✓l�i���C/Gv?ti.�. <br /> �/e.Uc,J G.9sf%;o,k�� G9.S�a� C�� 11�.�1'�'�� !r>�el!!�/�; SrA�i- Tc'sT •U�^ccJ <br /> MECHANICAL PE RMIT APPLIC TION PLUMBING PERMIT APPLICATION <br /> Type ol Pro�ecl: _ ew_Addn _Alteratlon_Repalr Type of ProJect: _New_Atldn _Alleratlon_Repalr <br /> Shaw Number(a)ol lirfures Show Number(M)o/l/rtures <br /> NC-air hantllin units Tailet <br /> Forced air s stems Balhlub <br /> Gas pipin Lavalo (wash basin) <br /> Water healer Shower <br /> Gas lire��lace Kilchen sink 8 disposal <br /> Gas ran�^ Dishwasher <br /> Clolhes tl er Clolhes washer <br /> Ran e hood Waler healer <br /> Ezhausl lan Sink service/barlmo letc.) <br /> Heat pump BackBow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlain <br /> Relri eralion Floordrein <br /> Woodstove Grease tra <br /> Ductinq Roof dreins <br /> � Other • Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Olher: <br /> Number of Heads O�her <br /> I��,e:e�Y�ertSy Il�al l�avo read anJ eaamned t�ia applcnUOn and knor!Uo semo lo Oo Wa unE wrtaci.NI p�ovifionf olAtwe ond e�d�ancef pavemhp V�if rype ol woik mi Ce comGl�.eJ <br /> �.�h wtieiner speo(reJ lierein or not.IDe prenUnp ol a panni�Doe�nol prefume la pne ouNonry lo vlolale or cencel t�o pmvison ol any oNer stala or local�w republin,7 conslmcl:on <br /> ❑�,ai i u:�auV�oniea�y��e o.vner ol iqi�O�opeM�a Ce�orm I�e woM1 br w�kh app4<alion ie maEe enC I romply��N t�e Slaic Convacton lew iB27 RCW an�29d i00A WnC. <br /> ,�>l��t� �C����,�� �"�-/G �'�3 <br /> � Owncr�Authodz ent SignaWrc Dale (Revised fi'I012) <br />