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PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257 8810 FAX 425-257-8857 www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM <br /> SITE ADORESS: PROVEP7Y TAX M P IT• <br /> 5 — 2 <br /> LEGAL for new wnstructiore ShoA PlaVsubdivision Lot No._ (atlach copy oi long legal Aeseription) <br /> OYYNER � i FQ/ML( /K 1'1' Pnone�E�ma�� y1 200—� 6 / /'QA� L� N�►GM �d� <br /> Address Z g�y � CitylSlalelZip <br /> APPLICANT: Owner �COwner•. ^qenl Contractor ConlraclofsAgem Tenanllm„�icroaoaaror.«oimnsem;m,wwr,•noao.oinunsD+�ol <br /> CONTRACTOR O L 8 I Lic.M AM�o�GL S8 3�E Bus. Lic.k <br /> AdEress PhonelEmail ZOQ — O 3 6 / <br /> NAN U I ESS A C NTACT FO ERMIT <br /> �a�d�y) Gao�o.e. <br /> Phone�E-mail Q p � .( r'�ldM �CR , C <br /> BUILOING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Ezisting Use o(Building � HEAT SOURCE: <br /> Proposed Use o(Building fl u t—G� Gas Eiectnc Oiner <br /> Building rype: _Single Family _Dupiez_Townhouse _Multi-Family _Commercial <br /> T �of ro'ecU � � New � Adtlition Remodel Re air -T.1. Si n Sprinkler � Demolition Chan e ofUse <br /> DESCRIPTION OF WORK�addrtionei speca p/ovidea on rha Cack�: <br /> �B�o � Q�,r�� �°�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> typs ot Pro�sct: _Now_Adtln _Altentlon_Repalr Typ�ol ProJect: _New_Addn _Alhntlon_Rrp�ir <br /> ShowNumDer(i/ ofllxfurc� SAowNum�er(N)o//Irtures <br /> A/C—air handlin units � Toilet <br /> Forced air s stems Batnlub <br /> Gas pipm � Lavato (wash basin <br /> Waler heater Shower <br /> Gas fireplace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Waler heater <br /> Exhaust(an Sink(service/bar/mo lelc.) <br /> Heat um Backllow reventer <br /> Und heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floordrain <br /> Woodstove Grease tra <br /> Dudin Roof drains <br /> Other Mediwl Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM � Otner: <br /> NumberofHeads � Olher: <br /> 1 hercby uMy Ihet I Aeve read enE eaamined I�ie appicalron arM kmw the same lo be true entl corted.Atl provisbns ol laws ar�O ord'nances goveminq I��s type ol wak wi1 be compmE <br /> wM wTelner:petKeE�ertin or nol.Tlie pfanling a1 a pelmtl Caa not prcsume to phe aVlnorlly to viola!e a cancel l�e provision o1 eny Nner c181e a bnl law rtOulNmg cOnstnn.tian <br /> Thal I em MliorlxeC Ey Ihe owner o11Ms proDe�y to perloim Me wak im�Mkh aDP�iolbn b meEe anC I campry wn�t�e Staie Contradas Lew 78.77 RCW mE 2%.700A WAC. <br /> � <br /> Ow o psnt3lgnstun Date (Rovisea620f2) <br />