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rERMIT APPLICATIO� <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF FVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> _ �7—/� <br /> SITE ADORESS: ��1 �� PROPERTY T� � ^^ PE I'N ' M� <br /> w w <br /> LEGAL for new constmcGon: Snon f•�,us�om��s.o� tS�o._ (anach copy ol Ibng legal desuiplron) <br /> OWNER �U Q� 5 PhonelE-mail a5- 0- Sy 5� <br /> �aares5 (�� � �'"�5 '�. a e ayg CdylState2ip W,Q• <br /> APPLICANT:_Owner _OanefsAgenl _Contractor _Cantracror'sAgent �TenaM�m�sipro„ceakeerorcw,so��,namvewor.uao»:nmr,.espaco7 <br /> CONTRACTOR C� State lic # Ciry Bus. Lic # <br /> AtlUress Pnone�Email <br /> ON AC F I <br /> � Q� 'C�ls v�n�aqe C�Ios�-� .y� J �n/1 �I M VY�'�(- <br /> PhonNE�matl �I��(,� •'�"-�lw` a �O"`C��" `�' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK^ � <br /> ExisGng Use of Budding f� HEAT SOURCE: <br /> Proposed Use of Building Gas � Eiectnc_ Oiher_ _ <br /> Builtling type: _Single Famity _Duplex_Townhouse _Mulh�Famdy �Commeraal <br /> Type of pro�ecC New Addition Remodel Repair 7.1. Sign _Spnnkler_Demoldion Chan e ol Use <br /> DESCRIPTION OF WORK Iadc;nonar spa:e umwacd a�me nackl <br /> `�pl�wooc� �a.�nke�4 s���� t a� bbt� e�l -b �} -E'n��d.�- <br /> �'� x I Z W,�de (o��fR� on C��-(/�� <br /> � <br /> ME HANICAL PERMIT APPLI A 1 N PLUMBING ER 1 LICATI N <br /> TypeotProjocl: _New_Addn _Alte�atlon_Ropair TypeofProject: _Now_Addn _Alteratian,Repair <br /> Show NumAcr(N)ollirturns S�ow NumDer(a)ol liriures <br /> NC-au handhng units Toilet <br /> Forced av systems Bathtub <br /> Gas pipmg Lavatory�wash basm� <br /> Waler healer Shower <br /> Gas freplace Kitchen sink 8 disposal <br /> Gas ranne Dishwasher <br /> Clothes d er Clothes washer <br /> Range hootl Water heater <br /> Exhausl (an Sink(servicelbadmoplett.) <br /> Heat pump Backllow preventer pnside bld9) <br /> Umt heater Unnal <br /> �oiler Drinking Founlain <br /> Refrigcrahon Floor drain <br /> Woodslove Grease Irap <br /> ❑uctmg Rool arains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other. <br /> IJumber ol Heads Olher <br /> I Ane6y cenRy I�at I have reaU and emmineC I�rs nppliwtmn anC Anow Ihe w¢e lo be Irue an0 tortecl.Ap pmvrslons ol wws orG vrO:nances goveming IL.S tYpc ol wvd w.7 be complreE <br /> wm wtiemer specdma�erein ar not.i e gnnung al a pttmd Caes not presumr to grve auNamy to�ioia'e ar eincel I�e praviswn ot uny ol�er slate or bwl law regWaun9 consiructan <br /> T�al i nm aulllonzed ��e ownero� �is Drope�y lo pe rm IhC wo�A lu_wprt�ippbWlron i maae ana i compy vmn me S�aee Camraeom iaw ia z�acw ano 2es aoo,�wAc. <br /> 7/ �� <br /> wnar tnorizeOAye gnature � � t (Revisetl4?Of`) <br /> ��Z <br />