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PERMIT APPLICATION <br /> BUILDINGIMECHANICALfPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www•everellwa.org <br /> SITE ADDRESS: PHOPERTY TAX p PEftMIT# <br /> o L'> Gn�+,�� Av� °� � <br /> LEGAL for ne�v consUuclion: Short PlnVsuhdlv�sion Lot No._ (atlach copy ol long legal description) <br /> OWNER Q.t7T s - M '�,A��p PhonclE�mall O�o ' U—Y7 �Z- <br /> Address �Ol S ROh � c��yisi�«rzia /; 9$ 1�(� <br /> APPLICANT:_Owner Owner'sApenl foniraclor _ConiraclarsAgenl _TenaN�m��two�aaaiena�mconuntnormocMne�meowoa�nmo�Pa�o� <br /> CONTRACTOR V 4 Stale Lic.# 5 c Cit Bus.Lic.# d$� � <br /> nddress �S7 ' ~"t'� "¢C— �L � PhonelEmail Lj Z — S6 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Pq�� Mv��s yzs 9os-Q�Q� <br /> PhonN6mail � � � e • �J <br /> BUILDING PERMIT APPLICATION coNrRAc7 PRICE oF wOR `' <br /> HEP.T SOURCE: <br /> Existing Use of Building ��� <br /> Proposed Use a(Building�[—le — Gas✓ Electnc_. Other_ <br /> Building type: ✓Single Family _Duplex_Townhouse _Multl-Fami�y _Commercial <br /> Type of projecC _Nevi _ Addition ✓�temodel ✓Re air__ T.I._Si n S rinkier Demolit�on Change of Use <br /> DESCRIPTIONOFWORK(add�tiona�spacepmvldedontnoeack): k�OOEZ- OP ExISTS^�La �� 6�- � bn ���tC , <br /> NEW �Ya CqW� f�oaF- a� tFDus� � C•>Aaa6C� niEw fwy'saG , l�ZTZN6.� U+�3wET�, I3kT7/ 71$, <br /> �Eq1kETErr �.rr�+oot�, :.�"�-� � ' — , R.�r+ovF DOM6Bo <br /> CN'T..-^'�K�Y. 3ZDiNCa rtJ'�S11� P�.v,"�r3s..`G Rc.p��,L.z Ai nlEe'�cv, DQ-YMALL � oui�Tt�l <br /> -At <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ot ProJocl: _Now_Addn _Alleration rRopalr Typo ol ProJect: _Nuw_Addn '�Ituratlon✓Repalr <br /> Show Nam6cr(7!)olllxfures Show Numbcr(N)o/lkturcs <br /> � A/C—air handlin9 unils � I Toilet <br /> I Forced air systems I Bathtub <br /> Gas piping I lavatory(wash basin) <br /> Water heater � Shower <br /> Gas fireplacc � Kitchen sink&disposal <br /> � Gas range Dishwasher <br /> � I Clothes dryer I Ctothes v+asher <br /> � Ran e hood I Waler heatzr <br /> � Exhaust fan I I Sink(service�badmop/e1cJ <br /> � Heat pump I BackOovi preventer <br /> � Unit heater I Urinal <br /> � Boiler I Drinkin Fountain <br /> � Refrigeralion I Flocr drain <br /> � Woodstove � Grease trap <br /> �uctin I Rootdrains <br /> � OtF��r � MedicalGas <br /> SPRINKLFR / SUPPRESSION SYSTEM j Other <br /> � Numberof Heads � Olher. <br /> I hemby cert�,ly Ihot I h�+a reai ond aam�ned Ihls aFGi'<a5on ond know Ihe sama to 6a bue and co�rect.A1 proWsbm ol laws and ordinancef goveming Nie type of wod xiil�a comp6e7 <br /> �,u:h v:heIDer specifred herein or not.7Ta gronimg ol a permit dae�e1 preeume to g'no authoMy to vmtalo cr cancel t�e pmvision ol any other etate w laal taw regu:at�np cons!ruclion <br /> TP,at I om auihonzeC by Iha onne�ollhb p�opMy lo pedortn Ne xmk lor e,Tich applkatron�s maCe anC I cempy wM N.e Stete Crntrecton lz.v 1B27 RC'Ne�tl P98.200AK'AC. � <br /> � <br /> G'�`17 <br /> O rnorlAuthorizod Agent Signaturo <br /> Date (Revised 32073) <br />