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� <br /> � I . <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �a�" I Zi <br /> SITE ADDRESS: �z ^ �£_ L S '�2 PROPERTY TAX p PERMIT��_�2 <br /> _� ,.�� <br /> LEGAL for new conslructlon: Short PlaVsubdivislon Lot No._ (ettach copy ollang legal descAplion) <br /> OWNER �c�R G 1�1��. 1 " �°t c���h J PhonelE-mail � 0.�f�K C ��UW J l3. o Q�i- <br /> Address G.-2`1 1 �C K S 1��L. CilylSlatelZip Z � E�-`L 7T <br /> APPLICANT: Owner Owner'sAgent Conlraclor '�Conlractor'sAgent Tenan�(mus�pro�ia�lenerolcauanlhantnewnxloeowanlnuwspacel <br /> CONTRACTOR � L f3rz..:.�kS G'�-' L&I Lia ff ���kC�' �� J � COE Bus.Lic.# <br /> Address �2 � �j Ni 1 � C fU I`FN�nJ PhonelEmail 20 6• ?i�u� / S� � � <br /> TE ANT U INESS NAME CONTACT FOR PERMIT <br /> �1e-t_'F i�R�..� k s <br /> PhonelEmeil 2r�C> ' S�� ' /.� � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3ooc� <br /> Existing Use of Building Q�-S• J £ tic � HEAT SOURCE: <br /> Proposed Use of Building Gas eieclr�c Oiher <br /> Building lype: _Single Family '�Duplex_Townhousa _Multi•Family _Commercial <br /> T pe o( ro'ect: New Addilion Remodel Repair T.�. Si n Sprinkler Demolition Chen e of Use <br /> DESCRIPTION OF WORK(additiona�space provided on rhe beck): <br /> �� . r��� r- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ot ProJacl: _New_Addn _Altentlon_Rapair Type of ProJact: _New_Addn _Aksnllon_Rapalr <br /> Show Number(N)o/flxfurea Show NumDar(N)o/flxtuns <br /> AIC-airhandlin units I Toilel <br /> Forced air s stems I Bathtub <br /> � Gas pipin I Lavato (wash basin) <br /> Water healer I Shower <br /> Gas fireplace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clolhes d er I Ciothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink servicelbar/mo /eta <br /> Heat ump BadcBow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> � Refri eration � Floordrain <br /> Woodslove Grease ira <br /> Ductin I Rootdrains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> Number of Heads � Other. <br /> I hereEy cedM�hat I hava rced and e.amined Ihia epp�catbn and know Iha seme la be we and cortat.N p�oviians ol lawa end oNinancm povaminy I�is rype o/xark wJ be compfed <br /> µiN whet�er specilkE hereln ar nol.iTe qnming ol a perm�Oow nol presume 10 gNe aut�ority to vblNe a wnal Ne provisbn W xny ot�n�tale a bcd Irw regul�it�g con�ivabn <br /> il�a�I em eN�orizeE Oy Ne owner ol Nte property�u pMwm Ne wak fa vA�kh appiiwtbn b maEa�nd I oompy wM Ne Slale ConbMaa Lrw 1827 RCW�nC 298200A WAC. <br /> ��� <—�� $-. Z y. I'L <br /> - - .a..:.,.,.<��.,� <br />