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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/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 /> � - S - �5 <br /> SITEADDRESS: I ��(� ^`lr' �S �W� OROPERTVTA%p �� ;Q/� Q PRMIT��I D� <br /> I � l` <br /> LEGAL�cr new construcUon Snort PlaUsubdrvlsron Lot No_ (attacn wpy of tong legal tlescnption) <br /> OWNER o�(G5� � ��� � Phone�E-mail\`,�� ��Q —�� ��� <br /> ntltlress � �a9 ��l-�CaS �uQ_- Gry�StaleRip (' (� � 25 �-� <br /> APPLICANT:_Owner _Owner'sngent _Conireclor Contractor's _ . ,. ., r.��..e�o.��.. ..•... ,wn�.,ino+c�c.� <br /> CONTRACTOR 1'11��21f' S Q«Q�� �'h State Lic # ��� LI City Bus. Lic # <br /> 3 nGEress JW10 i� � �1� C PhoneiEmal O�� l OL �6 <br /> � TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ��� n 52.��- <br /> PnoneiEmad ��a5 �70- b� 2�� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3b��• �7 <br /> Existing Use of Building HEAT SOURCE. <br /> Proposetl Use of Buiiding Gas Electuc Other <br /> Bwltling type� _Smgle Family _Duplex_Townhouse _Mu1ti-Famdy _Commercial <br /> T e of ro'ect New Adtlilion Remodel Re air T.I Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(aomno�ai space pro�ided on rne eack�: <br /> �29���, -�-e a� �n^-� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ot Prajecl: _New_Addn _Alleratian_Repair Type of Project: _New_Addn _Alteratian_Reo�ir <br /> Show Num�er e o//iirfures Show Number # af lixmres <br /> NC—air hantllin uni�s Toilel <br /> Forced air s stems Bathtub <br /> Gas i in Lavalo wash basin <br /> Water heater Shower <br /> Gas lire lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes tl er Clothes washer <br /> Ran e hootl Water heater <br /> Eahaust fan Sink sern[elbar/mo /etc <br /> Heat um DackOow reventer inside bid <br /> Und�r Unnal <br /> Boller Drinkin Fountain <br /> Reln eralion Floor dram <br /> Wootlsrove Grease«a <br /> Ductin Rcol drains <br /> Olher Madical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Otner <br /> Number of Heads Olher. <br /> I nereDy cenRy i�ai I nave reaC an0 e.am-.netl N��s app��w�ron anE know me same io Ee we anC wrteci Ni O���s:ons ol iaws anE oN��ances govem�ng ims ryDe ol work wii Oc wmW <br /> vnm wneiner spea4etl n?rrn rof Tl�e gram�ng ol a Dennil Caes not pmsume io grve amnomy io v�oia�e or rancel me D���son al any oi�er state or iowi law regNatmg comwcuo� <br /> T�at I am auln nze0�y t owner o/lnis pmOeM�0 7erlortn��e warA lor wNcn aDD��i:on rs maCe an01 comply wan Ihe SIa1e Com�aclars Law tB 27 RCW an0:96 700A WAG <br /> aS � s <br /> n in6rizedA S� ature � Date (Revrseda2015) <br />