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( '. <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBINGISIGNISPRINKLE WDEMOLI110N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPUCAT�ONS ARE ACCEPTED FROM!AM TO 4 PM �""IZ"� <br /> SIT ADDRESS: PROPERTYTAIfN MIT <br /> �� � ��, � �Je7 tI <br /> LEGAL la new consWnion: Shal PIaU�ubdlWabn Lol No._ (attech copy ol bnq kqol OefcApibn) <br /> WNER .:y� .��� PhonelE•mall <br /> ddresa � CirylSlatUZip v{(t ({ <br /> CONTRACTOR , L L 61 Lic.N C f O ti 0 � � <br /> dEreaa If I20 I�I��^ c. B ih4-11 W O l PhonNEmaN 3�-oru <br /> TENANT BUSINE NAME C TACT FOR PER <br /> W ' � PMneIE•mall Cy � -u64 3 �L � <br /> BUILDINGPERMITAPPLICATION coNTruCTPRiCEOFwoR <br /> Exieting Use of Building 0 FY'�cc ri.f2G HEAT SOURCE: <br /> Proposed Use of BuiMing o fF' c c n: C t _ Gaa � EIMr�c Otner <br /> Buiiding type: _Single Family _Duplex Tawnhouse _Multi-Femiy �CommerGal <br /> Type of project: _New _Addkion _Remodel _Repair�(T.I._Sign_Sprinkkr_Demolition_Chenge oi Use <br /> D85uiptionofWork(addifionalspacepovidedonf�ebeck�: ��aT� '1 StitL�rO��C Z �ar����� vR��3 � a.✓�C� <br /> I �� � <br /> �� n5�a11 n 3 O hcilcW wc�1a� �acr .�-.d Fr�M�- . <br /> Havs you sUrted worldrW�vRhuut a Pe�m�t7 _YES �NO <br /> MECIIANICAL PERMIT APPLICATION PLUMBINO PERMIT APPLICATION <br /> Typ�of ProJat: _N�w_Addn _AIUraUon_R�pNr Typ�ol ProJecl: _N�w_Atldn _,Alantlon_R�ydr <br /> Show Numbx(p o1 HRuns Show NumA�r of fl�� <br /> AIC-airhandlin units Toilet <br /> � Forced air s stems Bathtub <br /> Ges i in laveto wesh basin <br /> � Water heater Shower <br /> Gas fire lece KRchen eink 6 dis osal <br /> Ges ren e Diahwasher <br /> Clothesd er Clotheswasher <br /> Ren e hood Water heater <br /> Exhaustfan Sink servicelWrlrta etc. <br /> Heat um Badcflow roveMer <br /> Unit heeler Urinal <br /> Boiler Drinkin Fountain <br /> Retri eralian Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof dnins <br /> Other Medical Gaa <br /> SPRINKLER I SUPPR88SION SY8TEM ���� <br /> Number o(Heada OtMr: <br /> I hereby certiry Ihal I have read aM examinetl ihia epplicetlon end knav the ume to 6e true and correct.All proviaions ol lewe pnd aEinancea 9�minp <br /> this rypa ol work wlil be complied wit�whether apecified herein or not The pranlinq ol a permit does nW proaume la pive euNodty to vblate or ancel <br /> the provision ol any state o�iocal taw repulating cons�rucllon or iM pedoimance ot conahudbn.TTsI l am authorfzed by the owne�of t�is propsrN <br /> to pedorm tne worlc lor Ich applketion Is mede an0 I compy wilh IM Shte Coniroclon Lew 18.27 RCW anE Y98.200 WAC <br /> F. _'_'_ i7�7'�'/ <br /> OwnerlAut odzaC Ay�nt Sipeatun Dale (Revieed 7/POH) <br /> �a <br />