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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wwav.everettwa.org <br /> ; .S -1��-��{ <br /> SITEADDRESS: PROPERTYTA%11 P MITk ,� <br /> � �fOS -00 <br /> LEGAL for new conslruclion� Short PlaUsu6tlivision Lot No. (allach copy ol long le9al descnption) <br /> OWNER � �� /��— PhonelE•mali Z� r' r � � b� <br /> Addmss 6 � �v-� Cdyl5lalMZip W /� p Z� � <br /> APPUCANT: �ner OwneisAgent _Conuacto� COnlfacl0i5AjC�1 _TEOdnl�masip'ordoaianere�wnscmlronmoo+ner'oEowoM1ininospaae) <br /> CONTRACTOR �( �-- Stale Lic. N City�us. Lic.# <br /> Address �d �,V.-�--- Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of BaJding HEAT SOURCE� <br /> Proposed Use o(Building Gas_ Electnc_ Olher__ <br /> �uiltlmg type _Singte Family �Duplex_Townhouse _64uIti�Family _Commercial <br /> Type ol pro�ect Nev� _Adddion _ _Remodel _Repair_. .TJ _Sign_Spnnkler _Oemolition_Change ol U5= <br /> DESCRIPTION OF WORK(addrnonai space n�o'��ded on rhe back)-. <br /> �,.*�'QsI�RRFcTbNs As 2rQu�rzry A+�� a�rt�ra� i� co�� <br /> cN Ta�c�.�-•anxT V 1 O LA i�'�n1 u�,�+i ia N t7.r�i� ApQ �8, � 'd � <br /> Gs�SE �.1 Gc` i 4-0 2 7 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projecl: _New_Addn _Alteralion_Rrpair iype ol Projecl: _New_Addn _A�Ieralion_Re�alr <br /> Stmw Numbcr(M)ol lixfures Show Number(H)ol lixlures <br /> NC-air handling units I Toilet <br /> � Porced air systems I t7athtuu <br /> Gas piping I Lavatory(veash basin) <br /> Waten c�ater � Shower <br /> Gas lireplace � Kdchen sink 8 Aisposal <br /> Gas range Uishwoshcr <br /> � Clothes drycr � Clothes washer <br /> � ftange hood Water heatr.r <br /> � Exhaust�an Smk(servicelba�/moplelc) <br /> � fleal pump f3ackflow prevenler <br /> � Umt hcaler I Unnal <br /> � OodCr Drinking I'ounlain <br /> � Relrigeration � bloor drain <br /> � WoodSlave Gicasr, Irap � <br /> Ducting I Roof drains <br /> � Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � otl,er <br /> Number ot Hcads � Olhcr <br /> 1 ro:m�y r.etlAy 1�a1 1 ham reatl anE cramineJ Ih',appl¢aLon m�d/now�he sama lo ba Imc and coiretl All pmvrs�ons oi la,vs and ordmunces govermng I�is lypo ol wmk wll6c rompbetl <br /> vnll�w�clne!speafeJ hc�cin ot nr.l T�e gianling ol 0 pertn',I does nol presuma Io gne.lul0outy lo vio�ale or wncel I�e prev�sion ol any olher sla;v or loa�l�a'x�egulatia9 mnslmction <br /> I�at I am aulhoriicE Uy nnc 11�- y o crlo�i��M1e�vak lo�wh�¢�app�.wl'o^Is ma�c ana I<anply wil�Ihc S�n�c Coneado�:�.�w 19 77 RCW en0 2^�]OOA W�C <br /> � �� 1 �� � <br /> OwnedAulharized IR)enl5iynatum Ualc (Rev�setl3Q013J <br />