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� � <br /> PERMIT �►PPLICATION <br /> BUILDING/MECHANICAL/PLUiVIBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF E�/ERETT PERMIT SERVIC.ES <br /> 3200 Cedar St., Everett, WA 98201 425-257-3810 FAX 425-257-8857 ��n^.�v everettwa org <br /> SITE ADORESS: �ROPtR7Y i�X N P fi11T 0 �_ <br /> 5'/a V� <br /> LEGAL Icr ne.v consVuclnn� Shen PIaUs�Omvfs�on Lm No_ (auach copy ot iong icgai Oescnpi�on) <br /> OWNER p7..,� c � Phone/E-ma.l <br /> Ad�ress Ctly/StalMZip <br /> APPLIO(1NT:_CwnCr _OwrCr'SAgenl �ContidC;Cf _COnIr3Clor'SAgenl ien;inl(����tp:c�eoa�e-e�arrese��i�omt�aa.ner!oaa..c1m�naspacr� <br /> CONTRACTOR / C�2 'c a o ='✓ State Lic. � /� SCS G City f3us. Lic.# <br /> . <br /> FCCress .?/S �VL J s'N��i. Pnone�Ema��l � 3Sa - « >i <br /> TENANT BUSINESS NAME CON7ACT FOR PERMIT <br /> Pnone�E•ma�i /d' ,$= 3 So � GGL <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_[O n�� <br /> E*�stmg Use of Builtling���`di.��e HEAT SOURCE. <br /> Preposetl Use cf�wltl��ng Gas_ [�ectnc _ Other___ <br /> 8u��:dmy type � S�ngle Fam�ly __Duplez_Towr.house _tJlulti�Family _Commercial <br /> iype of pw�ect New Adddion Remodel Rcpa,r T.I S�gn_Sprinkler.__Demo!d�cn_Change ol Use <br /> OESCRIPTION OF WORK;aad�nenaispaceFrordcdon�ne�acw) <br /> Te/J-R p�� rx�s%'fy -� 1-/' r�rs R.or., y�vsTai, '/2�' co,t' f/yu,��a <br /> o � rk�ld S� �•�..:� I�r ivud�� '-,.sTnai .7o Sh:�6/� <br /> MECHAlJICAL PERMIT APPLICATIaN PLUMBING PERMIT APPLICATION <br /> Type af ProjetC _Hew_Addn _Alleralion_Rcpair Typo ol Projetl� _New_Addn _Alleration_Rcpair <br /> Show flumber(p1 olliHures Show Num6c�(Y)ollirhves <br /> NC -a�r handling units I Toi!el <br /> � I-orced air systems � Bathtub <br /> Gas n�Uinq Lavatory p:�ash basm) __ <br /> � Water healer � Shower <br /> Gas lireplace I K�tchen sink 8 disposal <br /> � Gasrangc Dishwasher <br /> ! Clothes dryer I Clolhes washer <br /> ; liange hood Water heater <br /> Lahaust lan I Sink(serv�ce/barlmopfelc) <br /> � Heat pump � Uackllow prevenler <br /> � Umt hcater I Unnal <br /> � Bmler Dnnking Founlain <br /> Relr�geration � Floor dia�n <br /> � Vl'oodslove I Greasc Irap � <br /> UucUng I Roof drams <br /> � Olher I hiedical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Otner <br /> I Num6er of Heads i Olher. <br /> I here�y cemfy ihal I have rcad nnd e.am ae�Ih�s aF���=��•���^d tnmv ISe same to Ee Ime an0 wrrecl A!1 pmvisions ol�aws and or0inances 4oveming Ihis lype olwork wv'I Ce m^�pFe;f <br /> w�'��wnel�c�speu�etl he�ern or nol ine 9�anling ol a permd Eoez not piesume lo give aulnonly Io viplale or cancel Ine piovision o1 any olner sl>Ie or lo�l law mgviatmg constr�cl�cn <br /> t�al I am aN�on¢ea Cy IPe or:n^r cf ih,p�eperly to penonn I�e xo�h lo�w�rc�appnwba�K maCe anC I comply with t�e Sla'e ConVacton Law iB 77 RCW anC 796 2COA WAC. <br /> �� /e�� <br /> Own Authorizcd Agenl Sig ature Dale (Revised 3R073) <br />