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P�RMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGN/SPRiNKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3240 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 t^n+nv.everell�.or�� <br /> .,� <br /> SITE ADDRE55:�/� 1–���i� � PROPEPN TAX N �Rh� j�j# �oO Z <br /> � ry��� VV <br /> LEGAL lor new Conslmclron: Shc�t Plal�subda�lsion Lot No, (��i�d�eop�o'long legal tlescnptien� <br /> ' C'ONfq r� m, I <br /> OWNER (�}�/Q (� F�one�E�ma�l <br /> ' �9 Z D <br /> Address � E U � C��,�C ���Y,s�,«�zio E <br /> APPLICANT:_O�sner �Cti•:neisAgenl _Conirar.br __CoNracieisA9er,i __Teoanilm�e•,��cveeaiersictce-.eernrrn�.aowr.•�mta.oai.r�esca:e� <br /> CONTRACTOR y� �1' Stale Lic. # Cdy�us. Lic. # <br /> AdOress PhcnelEma l <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Fnonc/E�mail <br /> BUILDING PERMIT APPLICATION CONTRACTPRICE OF WORK 8I� <br /> Erisling U=_e oi Budding HEAT SOURCE: <br /> Proposed Use ef Building,�,�'S��E _ Gas__ Eiec:nc_ Other_ <br /> Building type�. �Single Family _Dup!ex ._Tormhou=e __A7uih�Family _Commercial <br /> 7yU��f V�o;ect IJew Add�;ion Remed�l RepaF_ T I. __ Sqn_S:rinbler Uemebl�.o,�ChanG� cf Us� <br /> — — _- i <br /> DESC RIPTION OF WORK l�C�'���^ai sp>cc o�o�-en cn rre c.raJ <br /> ,��,�,� ������� �,�,�N �� � ��y� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type et Proiect: _New_Addn _Aileratlon_Repair Type of PwjecC _New�11dCn _ Alteratlon_Repa�r <br /> Shmv Num6rr�p)ol fixtures Show Numbcr(�l ollufures <br /> NC –air handling unds X i Todel <br /> � forcrd air syslems � ������'�b <br /> I G�5�iPi��� � Lavalery(v+ash basin) <br /> � VVater healer Shw.er <br /> � � Gas freplace _ I Kdchen sink 3 disposal <br /> � Gas range � Disl���:asher <br /> � Clothesdrye.r � CIOU��esv�asher __ <br /> � Rangc hood � Waler h�aler _ <br /> —� E*haus�tan Sink(servieMbadmopiete) <br /> --r Heat pump Bac4'Iow preventer <br /> � Unit hcaler � Utinal <br /> � �odcr � Drin4ing Poun;ain , <br /> � Refrigeralion _ � Flocrdrain <br /> � Woodslovc Grease trap <br /> I �����i�� Rocldrains <br /> � Other,___ � Med�cal Gas <br /> SPRINKLER ! SUPPRES�IUN SYSYEM � p��,^� <br /> � Numbcr uf Heads � Olher� <br /> Ire¢t��cenJyi�atiha�.emaJande��inlmJthaa,pl:�xe�anC�.noxl`e:.m'�eloleiwrondcerrecl Allpmv�s:ensollawsandcd��anees5overninqlhisl�paolxork�el6ecempte•d <br /> ���:n��hether:penGeALe�e��narnul ineGran^ngolapem�ntice,nolpesume�ayneuun•.oNyloc.claleorcanceNnep�ons:onolaayciners�a'eor:ocxllanrtgul.ni-.gconshuchon <br /> ?nat I am autroi zro ty me ee��er r'i�e pw;eny lo pe orm I�e�vorM krnPic�app'r.calion is made an�I mmp!y wdh I�e Slate CeNra:¢rs L�w 18.17 ftCNar.7 2?F 20o411'AC <br /> ���0 �, ---°�9 °z -z��y \� 7 <br /> OwneNAul�A9en SI alurc • fl_�;+ �(�'r+�s�JJ:Ju1J) <br />