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PERMIT APPLICATION <br /> BUILDINGlPfitGiiANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Eveiett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM — o�S� <br /> SITE ADDRESS: -� r <br /> PROPERiYTA%k PE MIT# O� <br /> ���! J ��/ �'C.�d� �:�'fii:'F <br /> LEGAL lor new construction: Snort PlaVsubtlivision Lot No._ (attach copy of long legal desaiplion) <br /> OWNER ��;�. � , �i�:�. • PhonGE�mail 9/./ - <br /> ntldress /,.� ^`i�� �� Ciry�statc/Zip Et�f i•e'�J l,✓n �/J'2:� <br /> APPLICANT:��Owner OvmefsAgent Cantraclor _Contractor'sAgent _Tenantlmmivmwaaknero�m�somnommae«�m�oeownmmesc=ce� <br /> CONTRACTOR - rF lo��•- �� �/r;ir% �.� L 81 Lic.# "� . � � ������C,COE Bus.Lic.k <br /> .' .,� .� �7i PhoneJEmail v Z s' -3,-i '/'.'� '1 , <br /> Adtlress �/ �J � Ti� /i� ��� tF /1/C/_'. �1Tnr.�r[,�/�e �v G �v ��:. «� .,, , .._�t< r-= 4n�a,/ tc.;�, <br /> TENANT BUSINESS NAME ' CONTACT fOR PERMIT <br /> PhonGE-mail <br /> C���, %',�/�;' y2.5"-3dF-/9U'9 <br /> BUILDING PERMIT APPLICATION CONTRACTPRICEOFWORK�POO�� <br /> Exisling Use of Building <br /> � - • . �, � HEATSOURCE:�.. r � � �"v,^•• <br /> Proposed Use of Building � < Gas \ Electnc_ other <br /> Building type: i� Single Family _Duplex_Townhouse _MWti-Family _Commercial <br /> T pe of pro ect: _.New Addition ' Remode� _Repair T.I. Si n Sprinkler Demolition Chan e of Use <br /> DESCRIPTIONOFWORK/additionaispaceprovidedontnebacA): S`_�, � ��� �{� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProJect: _New_Adtln _Alteratlon_Repalr TypeolProJect: _New_Adtln _Alteratlon_Repair <br /> Shaw Number(N/ol/Ixtures Show Number(N)o//lxtures <br /> A/C-air handling units Toilel <br /> Force�air syslems � Bathtub <br /> G�s pipin Lavato (wash basin) <br /> ,:r,-;_ � Wa�er heater I Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> - � Gas range Dishwasher <br /> Clothes dryer Clolhes washer <br /> Ran e hood Water heater <br /> Exhausl fan �-J^� Siok(servicelbadmopletc.) <br /> � Heat pump � Backflow preventer <br /> Unil heater Urinal <br /> �oiler � Drinkin Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> � Ductin Ruof drains <br /> � Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads � Other: <br /> I nere�y cehAy that I�om rea0 ontl exnmine0lnb applkntion anC Anrnv I�o snmo lo be Uue ontl ecrtecL All pmvuiona ollam ond oNnancea Bovemng Ihh ppa olwork xil Eo wmplieE <br /> r.Ah e.ncl�er spe��ed herein or not.The prnnlinp ol o pem�it tloee nal presuma to qNe ouNony lo Wolale orcnncel lho pmtiebn ol nny o��er flnlo o�local bw repulatnp construction <br /> IDai I am outhOd2CC Oy�he ownc�OI Ihlf p�opeM�0 pBdOfm Na�4oA lonvhK�nppfKol'an la moEa ontl I compty wl�Ne Slate Conbetlon Lew 18.27 RCW nnE Y982WA N'AC. <br /> �(� /: �// <br /> �,/���l�� �'LL� C 'l�C�'�'�4— _.� �L���.1 <br /> OwnerlAuthodzed gent Slgnalure Da�e (Revisetl fi�201P) I� <br /> Z <br />