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� � . <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.orp <br /> APPLICATIONS ARE ACCEPTED FROM!AM TO 4 PM v �- <br /> SITE ADDRESS: �� ' p' , I�w j�— �{ M�RTriA%N PEnMit — <br /> r-� <br /> LEOAL tor new con�Wcllon: ShoA PletleuDtlivision_ Lot No._ (etl�eh eopy of lonp lepal ds�aipllon) <br /> ONMER � C. PhonelE•mall <br /> ddrou " D s Ciry�St�terzip � � <br /> CONTRACTOR � I^ ��� M e� A n �C.�� L R I Uc.� � <br /> �f6 ��. �)C PhonalEmail �� ��y <br /> BUSINE S NAME CONTACT F <br /> � / <br /> ,ol. S� o�S� 'P �ad.r,.�c1� � �o.' • ceh. <br /> M�� S Fine �oac+ 5 Phone�E-meN 3 <br /> dUILDINO P[RMIT APPLICATION CONTRACT PRICE OF WORK ��` <br /> Existing Use of Buitding HEAT SOURCE: <br /> Propoaed Use o1 Build(ng � Gas Eladdc Other <br /> Building ty : Sln I I _Duplex Townhouse _Multi-Femily ,_Commarciel <br /> T p� � _AddHion __Remodel _Repelr_T.I._Sign�Sprinkkr_Demolition_Chenpe of Usa <br /> 0 ledditfonal spece p�ovided on the <br /> r��. ,G/�/J�1 �ja�aP�o►'' C'G���,n� <br /> Haw you aqrtad workinlp rrilhout a psimlt4 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBINd PERMIT APPLICATION <br /> Typ�ofProJ�et: ,�N�w_Addn �Albnpon_Mpdr ryp�olProJ�eC _!Nw_.,Addn _Albntlon_MWir <br /> ShowNumbsr/yolflirfunt SAowNumWr ollt+hrn+ <br /> AIC—air handlin units Toilat <br /> Forced eir s atems Balhtub <br /> Gas i in Levato weah baain <br /> Water heater Shower <br /> Ges fi2 laca Kitchen sink 8 dis sal <br /> Ges ran e DfshwssMr <br /> Clolhes d er Clothea washer <br /> Ran e hood Water heater <br /> Exheust fan - Sink aervioelbedmo /etc. <br /> Heat um Bedcflaw reventer <br /> Unit heater Udnal <br /> Boiier Drinkl Fouolein <br /> Refri eretion Floor drain <br /> Woodstove Groaae tra <br /> Duclin Roof dreins <br /> Other T C / 000 Medfcal Gea <br /> SPRINKLER/SUPP ES810N SYS'tEM a�r <br /> Number o(Heads a�r: <br /> I hemby cerlify Ihal I have read entl examineA this applkatlon end kmw Ihe anma to be true end conM.All provlsiom of lavn�nd ordlmnat Dovemirq <br /> this rype of work will be complied with whelMr speclBed herein or nol.The pnnllrq of a pertnit doea not presums lo qive autMrNy to WoI�M or c�nce! <br /> the provision of e ot� tate or local law regulalinp conalruUlon or lhe pertam�oos o(conNruclion.Th�t 1�m�uthoAzed by tM wmer of this property <br /> lo peAorm lo Ich eppllution ta made and I wmpy wiln lM SI ta das L 18.27 RCW and 29E.200 WAC <br /> Own�dA o d Ap�nt Sipnatun <br /> /!� (FbWasd 7/1011) lla <br />