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, . C � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810-FAX 425-257-8857-www•evereNwa.ar9 <br /> APPLICATIONS ARE ACCEPTED FROM!AM TO 4 PM <br /> SITEADDRESS: �E�T�'T�� C�' 2.r-t' � -O <br /> 2S uCi�rL V� o , <br /> LEGAL for new construclbn: Short PIaVwDdivisian_ Lot No._ (attec�eoCY�lorq bpal EewiPtion) <br /> OWNER L% L�l�la V 1 L�.AL�E PhonefE-meil <br /> are5s ��' 1�.cr�c (3 2/� cayrs�+ertro E o-t iK-t{ fti�l g Zo(a <br /> CONTRACTOR C 1 u�� •/ S � H 5 �a i�c.« C (-!a IZ i S i 2 7 b f <br /> dress �7 0� N l- �7 S�` S f 1—C ln N�+U�-P � j$U Z � PhonelEmsi� �Z S �� 0 �'�� <br /> I NAME A I � <br /> �''�A 2C�'( �C� l� �S{0.L� �ci K't PhonelE-mail D�tivihA Uf�«v� l��'c Crc(a vr'I-y Sl ti S . <br /> SUILDINd �lRMIT APPLICATION CONTRACT PRICE OF WORK cX�n <br /> ic�r� <br /> Existing Use oi BuilCing HEAT SOURCE: <br /> Proposed Use of Building v Ges Ebctric Other <br /> Buildinglype: _SingleFamiiy _Duplez_Townlwuse _Multi•Famiiy r�Commercial <br /> Type of projed: _Nev+ _Addition _Remode� _Repair_T.I.�Sign_Sprinkler_Demolition_Change d Uee <br /> pesdiption of Work(additional spece rovided on fhe 6eck): <br /> / Y15 f'Ct lI �' .Sf�'� ��� C��C'h [.�'+AH Kt f �<' �IC Y.S <br /> �� 11a�� -i� I� v�, i'�c�(� c( bfu�' Sc�� S <br /> Hwe r«�surtea w«ar�w�mart a psrmro _res A'ra <br /> MECMANICAL �ERMIT AP�LICATION �LUMSINd �lRMIT A��LICATION <br /> Type o(Project: _New_AdAn _Allention_Rep�ir Typa ol ProNct _1Mw_AAAn _AIMnUon_Rep�ir <br /> Show NumDx(0 0l/lrfuns Slaw NunD�r M flaUw�s <br /> A/C-airhandli unNs Tdkl <br /> ForceC air s atems Bathtub <br /> Gas i i Levato was�basin <br /> Water heater Shower <br /> Gas ti2 Iace Kitchen sink 6 dis I <br /> Cas ran e Dishwasher <br /> Clothes A r Clothes wesher <br /> Ra hootl Water heeter <br /> Ezhaust fan S�Mc servitePoarl IMc. <br /> Heat um Badcflav reventer <br /> Unit healer Unnal <br /> Boile� DnMci Fountain <br /> Refri eration Floor drein <br /> Woodstove Grease tra <br /> Dudin Roof Orains <br /> Otl�er Medical Ges <br /> sPRINKLER/SU��RESEION sYETEM a�� <br /> Number oi Heads ���� <br /> 1 hereby csrtify thal I have res7 an0 examine0 ihis applicetion and know Ihe seme to be true end correci.All prwisiont o1�Bw�end ortlinancea pweming <br /> Ihis type of work will be comp6eC with whether specifiatl herein or not.The granting ol a permit doea nM prasume to pive suthorily to violale a c�ncel <br /> the provision o(eny other stale or ocol Ww regulating constniMion or the peAormance o1 conatruction.7Tat I em autlwrired by the cwnar of thit property <br /> b peAorm e v.ork�or wfiich e 0�1ion is maCe and I wmply with the Stete Contraclora Law 1827 RCW and 286100 WAC <br /> �fju�l2�tiU �-� S <br /> OwnerlAulhmized AgeM SI ura Dete � (Revised 7QON// <br /> 1/ <br /> � <br />