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I� <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITIO� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 425•257-8810 FAX 425-257-8857 www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM y..�-�-../3 <br /> SITE AD�RE55: PH07ERTY7A%p PERldITa <br /> I,Z• k=n�Gr/<.si'/_z�` '�� :• ' ��/ � l�, �- � <br /> � <br /> LEGAL'c:new c.ostru:bon S�.n Piavsuoaiv�sicn Lol No, (atta:h cepy o7 iong legal Cesa�ption) <br /> OIYNER �.Q"�C// f-�Ccty,✓�. /�u�7fp(,J,�7'�� Phone�Email /_� q �— �77-� � <br /> :-'�'s �/� � L����(� � G • Ciry/Slate/ZiD L'(�G'�C// ClJff, zl�� <br /> APPLICANT;_Owner _Owner'sAgent Comractcr Contraclor'sAgent Tenantimmic�,auwn.�cicomminomm•o�ai000wa�nr.s;,:e, <br /> CONTRACTOR ,��� ,�JG� /1�;(i�,�l',�j,9ii it� S SrG�6 t:4I L 81 Lic.#�G�lill $/(o�/(�= COE Bus. Lic.z / Q <br /> aaaress ..�;5�[j�, .SilYf 11/ (JC". /� � ✓l� l(l�. Phone/Emall � ' C�.��/�/uC� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �.��C m9y.v� - <br /> L"v���(�CT/�'Ct5�:�1 j/��i�r P�cne/E.mall���;�v.3-//Z� <br /> BUILDING PERMIT APpLICATION CONTRqCT PRICeoF WORK� O .00) �'��iC�/ <br /> ��-s!�ng Use ol Bwltling CSC/�^3Ui7/j� L�&l.r:��/�1�J HEAT SOURCE' <br /> i <br /> I��cFosea Use of Bmltl�n� ��/>�E' � / e Gas lecttic Omer <br /> u���a,ngtype�. Si gleFam�iy _Duplex_Townhouse ulti-Family _Commarcial <br /> t�rce ol pro�ecc �ew _Addition Remodel Repair .I. Si n Sprinkler Demoiition Chan e ol Use <br /> DESCRIPTIONOPWORK�aamt�ona�spa:eprovideacnmeDacy: J � � � <br /> � .�s;��;�lr.2 E /�cR- /��?Qrct'r d 2D/3-c�/ �a' !� c c <br /> ��Ji�itl� 4 /.k%Ccr�i/C� (�/)5 f-N�V.4�G �W"J�'/ iUeiCJ G'�Sr�ovU9CJ:_' <br /> ,'�,�r�.:i�,,�r•,2 �2.yI�JC.�,� I�tJC/cesiLE c.�F r1/e /�vr/ucc��;1J6 .�7'��f�✓l/��7dU: i�CRi�?U.� e' <br /> ��ir.Ucr» G9s � <br /> � F��,;v� G9S�� �r� �J�.�l'�'�� l.��el �/t�c;Sr�i f�`i�si .u���� <br /> MECHANICAL PERMIT APPLIC TION PLUMBING PERMIT APPLICATION <br /> ��,na cl Prol�'<<: L ��'_A�Jn _Alleratlon_ReU�lr Typo ot PwjecC _New_Atltln _pltaratlon_Repalr <br /> Snow Number I�l al 6itures Shmv Num6er(a)ol/InureS <br /> _ ' hC-art hanU6ng uni15 � TDilet <br /> i <br /> I Forced au systems BathNb <br /> � Gas C�o�nq _ Lavalo (wash basin) <br /> I 4Vatcr heater I Shower <br /> I Gas hrep!ace Kdchen sink 8 disposal <br /> I I Gas r�noe Dish��asher <br /> �___ i Clo�nes tl �er Clolhes washer <br /> Range nood Water heater <br /> I Eahaost lan � Sink(servicelbar/moF�etcJ <br /> r I Heat pump Backflow preventer <br /> I Unit neater Urinal <br /> � _ I �mler Drinkin Fountain <br /> I i Refrigeration � Floordrain <br /> ' Woatlstore <br /> �� Grease trap <br /> _ Duct�nq Roof tlra�ns <br /> Other _ I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other <br /> Number of HeaCs Olher <br /> � r.i. ..'el f'.d.e�pJC�".Je�dn'+'.C1C:oJ�C:.:d:.=aand\rVrvlM1ofeT010Ea1NUn�ICCOrt¢CI.AIIp:or.1.P't]OIbNfOlt]CI�J1dncOfQOveM110pN�3npC:!N'pO,u:ilLeqp�p ': <br /> ��'� ..•.:c-��:e:'.c:neia:�ei�i y 1 ne�„reo;ry:.!�pire•�aces nvt prefume la p�a aul�onry lo vioWb tt cer:el t�o pwris�on ol any etber slale Cl locel bw�ep�4N;r q ccsn�.:;<a <br /> � � �.� --� -, ..n:�er:irv.��;;cpe;r���a,eecrn�.Neno:kicrwn��paCcucaboni�meaeendlwmpryr.In�naSialaConvac�ortlew1827ftC5Yan�23fi:pq��;,a� <br /> ` / i <br /> -i � 1 <br /> ��Ci�l�t t� K• �:��,�� C)����G ZJ/� <br /> unoer�.mnonzarjA'yenl Slgnature Oale i.,�_... <br /> . .S,:J&$'I7� <br />