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a25-;:2-1666 Ctd��EtiiING OS�t3am 0:-1;-;C15 1 'a <br /> P�.tMIT APPLICATION <br /> BUILDINGIMECHANICALlPLUMBINGISIGN/�PRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt,WA 98201 425-257-8810 FAX 425-257-BB57 w,+nv.everellwa.org <br /> SITE ADQRE55: • PPOPEkTYTNtk P RM,`T�[^ _ � <br /> 23Z.3 Mel�rr� -AJe. IJ�� <br /> !EGALIarnawco�sWd�on: ShodPlaUsubdlvislon lo1No._ (atlachcoOYotloapleqaldas�ptlonl <br /> OWNER �O W1 �QQ e Phvne![•mail Z� �� 5�72 <br /> AdEres� GIy151a1olZJp <br /> AppLiCANT: Ovmcr _Owneral.Bont �CC�IfdACf _CCt1If�dOrBA0Cp1 ,�TOI1Btll�'w��p�+'������e!mverMC�nwubEe�MhOs�pau) <br /> CONTaACTOR Cm �}Qa. ��r,.� 11 `L SlalaLic. �L�v1.,/fl� Cil Ous.11c.#��W�� <br /> Addros:. r'O ��� WA� qg�� Ph�n�mail �}25 259 l�l�l�lo _ <br /> TENANT NUSINESS NAME CONTACT FOR PEkM1T <br /> �bi� �t25 Z5q�abm�. <br /> P onolE�nall •�rn <br /> BUILDING PERMIT APPUCATION coNTw,cT PRICE oF woRK 7�2L dC� <br /> 6clsling Use al[3uild:ng_ HEAT SOURCE: <br /> Proposed Use of�cilding _ Ges_ Eiocmc_ oine� <br /> Ouildin9typo: �Single Famity __Duplox_Townhouse _Multi�Family _Commarcial <br /> T eol ro'ect New Add�tion Remodcl Repair T.I. Slyn Sori�kler Oemo'itian Chanae olUse , <br /> DESCRIPTION OF WORK(nddRonel apocapmvidedon rho neck): <br /> In�a,ll d.�v4iess hca�- �"'`1° s`16�-+�'� <br /> MECHANICAL PERMIT APpL1.:A7"ION PLUMBING PERMI7 AF'PLICATION <br /> TypaolPro;oct: _Now_/lddn �pilarallon_fiopal� TypoofPra)ucL• _Now_f�ddn �lorallon_Repair <br /> ShowNumhor M alflrturca 56owNumbar M olOrlu�oe <br /> A/C—oirhandlin unlls Toliet <br /> Forced elr syslems Ca!htub <br /> Gas I in Levpto washbasln <br /> Weter heater Shower <br /> Gas fre lace Kitcben slnk 6 dis nsal _ <br /> Gas ran e Dlshwasher <br /> Clolhes dryer Clolhes washer <br /> Iinn e hood Wafer hnalcr <br /> F�chauct fan Sink servicefoadmo /etc. <br /> Heal um Oackllow rp evenlor <br /> Unil heater Udnai � <br /> Uailer Orinkin Founlnln <br /> ReGi e�allon Floor dia:n <br /> Woodstove Grea[e t� <br /> Ductin Hoof dreirts <br /> Other Medlcai Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Olher. <br /> Number of Noeds Olher. � <br /> I�ereby wrWy Lhal i�wn reed ond eaT�nad Wf opp0uthn ond Inow Ihe eame le bo 4ue nnd mnctl.A�pmWien�ul lmva ond o�dinonu�0�'+e�^0�''�'YPa AwoA W.G ha mm� <br /> Mth whelher epeaT,ed hnrvin or noL The pmMng ol o portnil dova rol pie�umo�a pi�e outho�Y.yte vlolola o�rakel Ihe pmvlibn al nny alher�Wle or loeol I�w 20ublinp mnetru�bn <br /> finl I om eulhorvnd hY�he vwner al1N�pmpeny Ie FeAofm Ihe work far wb�d�epp5mllon I�mnde ena I com�Jy qiln Ilm Sln!e LonVndm�lnw 1 B37 RLW und 7B61DUA VlAL. <br /> 5�15 <br /> Ownor uthorlxadAghnl gneWm � Oata !Gavlsed9R01<) <br />