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� • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereri, WA 98201 425-257-8810 FAX 425-257-8857 wvu�a�everettwa.org <br /> �- a 3-r3 <br /> SITE ADDR£S5: PHOPERTY TAI(n PERMIT C <br /> �U <br /> LEGAL lor new constroclion. Shoq PlaVsubtlrvision Lol No. (attach coDY of bng IegalOescnption) <br /> OWNER I �11 Phone/Ema�l "1j-��(gQ'Q'ti��t��yQ���sm� ,� . <br /> l+dnress a, �� ((� � (A City/Slale/Z�p EV � �1 <br /> APPLICANT:�Owner _Owner'sAgenl Conlractor Conirador'sAgent Tenanilm„sira.,oea�en�rmco�;e-,inomc^.00.me�maowonmin»;p.,_�) <br /> CONTRACTOR State L�c # City�us. Lic. R <br /> nddress Phone.'[ma�l <br /> 1ENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone�E-ma�l <br /> BUILOING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Fxisting Use of BuJding HEAT SOURCE <br /> Proposed Use of Building Gas_ Eiecinc_ Other_ <br /> \� Budtlmg type: y�Smgle Famdy _Duplex_Townhou;e _Idulti•Fam�ly _Commeraal <br /> !�\1 <br /> 4V Type of pro�ed�. New �ddition Remodel Repair_T I _Sign_Sprinkler_Demoliuon Change of Use <br /> DESCRIPTION OF WORK �aed�aonal space prcvitled on rhs back) <br /> Ne,� I�o!-tUb Rwk v�� , �'e���,u� ol� eXio�iY� �.�. <br /> MECHANICAL PERMIT APPLICATION PLUM�BING PERMIT APPLICATEC3N <br /> Type 01 Project: _New_Addn __Alleration_Repair iypa ol Projecl: _New_Atldn _Alterotiun_Repatr <br /> Show Number�k)ol liahics Show Number(MJ ol/irWms <br /> NC �- a�r hantli�ng un�ts Toilet <br /> Forced a�r systems f3alhtub <br /> Gas p.pmg Lavatory(wash basin) <br /> Water healer Shuwer <br /> Gas liieplar,c Kdchen sink 8 disposal <br /> Gas rangr_ Dishwa5hr_r <br /> � Clothos dryer � (:lothes washer <br /> Rangc hood Wa�er healer <br /> Ii*hau>t lan Smk (servicelbadmoplelc) <br /> Heat p�mp � Backflow prevenler <br /> � UnA hcaler Unnal <br /> � l3oiler I Urmkinq 1-ou�la�n <br /> I Re(ngeralion I 1 bor dram <br /> Woodslove Grease Irap <br /> G.clmq � � Roul drains <br /> (J�hr.r f✓�ed�cal Gas <br /> SPRINKLER I SUFPRESSION SYSTEM � o0,er. <br /> Number of Fleads � Other <br /> i bereby cenly Ihri I have reuE anE c�zmmetl I��s ao0��=abon antl tnuw Ihe samo lo be�me end corretl MI provr.rons M law,nnC ortl�nance,aoveming Ih��type ol woik wi i h^�.omp'�v�1 <br /> wA�whel0cr speuiicU hc�r�n or no� i�e q�dnbng o�a permil tloe:no�p�esume lo givc aulhorily lo violUte or ca�ccl Rw pmvamn ol pny olhcr:tn�e m In!al Inw repWnlinq e���•,�ur;��,n <br /> ihnl I xm�ulhouictl�y I�C Onne�ol Ru5 4��pefly�o perlo�m I�C w0'1.�0�wlnt�nD7��calmn¢mp0e nn01 comp'Y w"���e Slale ConhB[Iat51 nw 18 77 RCVJ nnd 795 7(U�VJld; <br /> __� �'�,�/� <br /> OWncr/Autborizod Ayent Siynaturc U:+Ip (R�uc�'d�10171 <br />