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a.�4 <br /> � � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SEF.VICES <br /> 3200 Cedar St , [verett, WA 9B20i 425-257-8810 FAX 425-257•A857 vr,vw everettwa org <br /> SIT����2ES : , �JO/fy, PROPCNIYIA%p P IT� _ O <br /> y 7��U <br /> LEGAL lo�new mnstr�cuon Short PiaUs��Jnrswn lot No_ (allacn copy ol long legal ae:cnplmn) <br /> OWNEP� �� 4u5�.� ���i --rno���e�m � �S �3'� �oZ� <br /> a�a•��ss ' � � �L TiF.fc�1 cnY�siaicrz�a � f1'� /�. <br /> (iPPLICA�dT: Owr.et OwnBYSAgen1 CO�Hd[lor Conlid[10i5Agenl TCn�nl!��tip'0.�^.�al��Cef[onR�11'cmp!pwtelptOwoM1��Nai:aGe) <br /> CONTRACTOR L 7�QR.. CN7/�UCr�A*l StateL�c +t QCKS� 90 RG ��tyBus t.c # <br /> Q I p /� � M/i�I <br /> :.�aress I• Q 0 D . 3 anonciEma�i /.�C QiC./G ST I/L lOJ Cd',k' <br /> TENANT BUSINE S NAM17E CONTACT FOR PERMIT <br /> ]/�,/ nr� r D r <br /> L�VYLr// ��_ � (�r-� � i,' ano�er[�mae �,K t7l /1,��� <br /> .f..... <br /> BUILDING PERMIT� PLICATION � CONTRACT PRICE OF WO t cs5'I <br /> Erist�ng Use o�Bwltling HF T SOURCE. <br /> Proposetl Us= qf Bwlding Gas __ Eiectnc_ Omer__ <br /> BwlC�ng tyoe _Singte Family _DuF�ex_Tov:nhouse _�.tulli�Famdy _Commerc�al <br /> Typz ot ore;ect Nev+ Adtl�tion Remodel Reoair___ T I Sign_Spnnkle _Demoi��uon_Change ol Use <br /> �SCRIPTIONOFWORK/ardre-��spacee:o�-a=dor,rneca:tii � r� /� <br /> Fi�7pUti ��(iS�Ti�vq �u/1�aC�.`�j Ri� �nCti �/pC� 4 S��l�f� 11/ft� /-t/�i�JacF <br /> d T <br /> MECHANICAL PER IT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Pw�ecl: _New_Addn Alteratlon_Rep�ir Typo ol Pro�ect. _New_AaUn _Allemllon_Repair <br /> ShowNum�rr(t o(�i�fures ShowNum6er(plolfi�tures <br /> � 11�C—a�r h;�ntlhng umts 1 ?odel <br /> I forced a�r syslems � �athtub <br /> i Gas pio�ng I Lavalory(v�ash basin) <br /> � LVaten c�a�er I Sho�,.er <br /> Gas Oreplace � Kac��en smk 8 d�svosal <br /> I Gas rangc I U�51'..�asner <br /> I Clothes dryer I Gothes washer <br /> Ranc¢hood � Walcn c�ater <br /> � F�na�til lan I Smk(serviCelbarimop/eic ) <br /> � Heat pump I Backflow oreventer <br /> I Unnhaater ��Q�/qG � Unnal <br /> I 9oiler I �rinking Founla�n <br /> I Relrigeration I floortlra�n <br /> i Woodstove I Grease trao - <br /> Ducting ; Roof diams <br /> � Other j tled�cal Gas <br /> SPRINKLER I SUPPRESSION SYSTEM � Otner. <br /> � `Jumber ol H?atls i Oiher. <br /> i�e,ee�cen 1���ai I na.e rea�an�e•am�ac0 iR.s ap0'�a'����^�hrow Ne same q Oe�me anC cmr¢ct Ftl pmvsrons cl iaxs a�tl oNina�ces govemm3 t�ii lype o�woi/w.l�Oe mmp'�^0 <br /> .��+�=ine�spenf peie�n o�no�.ine gmm�.�g o� rmt tlaes nol pesume Io grcc aumoM�io r�oU!r o�wrcci�-^p�o.�s�.n ol any ome�s�a!e m iaeil iaw regu:almg mnstrvn�a� <br /> Ina!ia�naum eOCymeawne�oiin�sD�dCem Aermmeuo�Alorv�ncnapp'caf�onumaecanlicoT,piya�n�neS�aieCemrn:tonlawfB2lHCWana796i00AN'nC <br /> i � � � <br /> . � o,y <br /> OwneUAu�horizeOAgent gn�turc Da (Re��se07R0U) <br />