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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetiwa.org <br /> # g 5"�-06-15 <br /> SITE ADDRESS: PROPERTY TAX p PERMIT K <br /> .� Y P c. � R qiZ�l � S S—U�2. <br /> LEGAL for new construction: S�ort PIa1/sub0ivrsion Lot No._ (allach copy ol long legal description) <br /> i \_ <br /> ..•. OWNER.�GU�{ � - prlWC�� . . ' PhonelE-mail ��W��GJ�g1n'��c�1 .�r� <br /> � qadress' �/ 1p V�c:,'� �%� �Y�l Cdy/5ta1e1ZiD r,i��-e.�� i �F'• ��2�� <br /> APPLICANT: �O�vner _OwnersAgent _Contractor _Contraclor'sAgent _Tenanttm�+�wonaooi:n��oi�o�:o��i�mmrm.�erioao»m:�c�svaco� <br /> CONTRACTOR — ,�� p„r(,,,-�,� �;,)�,�,� State Lic. # City Bus. Lic. # <br /> Aadmss _ �� � ��; � Phonel[mail <br /> CONTACT f PER T <br /> . � PhanelE-mail <br /> BUILDING-PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> [xisting Use ot Building SFR HEAT SOURCE <br /> Proposed Use ol Budding Gas.__ Eie.cuic_ Oiher_ <br /> 0utlding lype. '�Singte Famlly _Dupiex_Townhow^e _Multi-Fam�ly _Commerciai <br /> Type of pro�ecC !Jew Addition ✓Remodel _ Repair_T.1._Sign_Sprinkler_Demolilion_Change of Use <br /> DESCRIPTION OF WORK(add nonai space provieed on rne back): <br /> � �e���Q\ -nl�n��r1�4�� S�-�.r Wrni _ 2CS1��.. c�2�;.f y�ar`c.ro� <br /> , <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: _New_Addn _Alteration_Repair Type ol Project: _New_Addn _Alteration_Repafr <br /> Snow Number(M)o!lixtums Show NumDer(a)o!/ixfurcs <br /> A/C–air handling umis Todet <br /> forced a�r systems �athtub <br /> I Gas p�pinq Lavatory(wash basin) <br /> Waler nealer Shov+er <br /> Gas fireplace Kllchen sink 8 disposal <br /> Gas renge Dishwashcr <br /> Clothes d er Clothes washer <br /> Rdltgc h00tl WdICf he3ler <br /> [xhaust fan Smk(scrvicNbadmop/cic) <br /> Heat pump E3ackflow preventer pnsde bidg) <br /> Unil hcatcr Unnal <br /> Oodcr Drmkm9 Founlain <br /> Rcingcra6on Ploortlrain <br /> Woodstove Grease Irap <br /> Ductiny Rool drams � <br /> Other P.ledical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other. <br /> Number ot Heads Olher <br /> I Oc�cUy eciLfy In;n I navc rrad a�W c�amincd Inn nppl�cnwn antl Anow I�c samc lo hc lruc anC em�ecl AA provisqns ol lows and o�tlinanGc.govcrning tnis�ype o�woik wl1 Oc�nmplmd <br /> wA�wtiel�a speoficE herc�n ot not Ihe qran!in9 0l a permA does not D�esume lo prve aui�ciity lo vw�aie o�u�ncN I�e p�ovision ol any olhci sixte or beil law regWabng conslructron <br /> Thal I am aW�omcO y Ihc nwnet ol i�is pro{wrtY�o pnlorm Inc work lor wMc�appl�cn�on i5 matic and I campty wn�Ihc Slnlo ConlraCois Lux 18 27 RLW an0 Y9G 200A WAC <br /> "7 <br /> W <br /> Owncr/Auth rnd Agont Signaturo Date (ReviseJ 4rJ015) <br /> 1I7 <br /> 4 <br />