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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-6857 www.everemva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � < <j — / 3 <br /> SITE ADDRESS: PROPERTY TAX p PERML; <br /> Iq3o M�a+u- G �qRi��JA �2-C.l'� <br /> LEGAL lor new conslruction� S�ort PlaVsuDdrvlsion Lol No._ (attach copy of long Icgal Gescript�on) <br /> OWNER 'E � u 'S TE Phone/E�maa <br /> Address �o o Q o$ Ciryf5latelZip L R L W 9 8 0 <br /> APPLICANT: Owner OwnersAgenl Comraelor ConlraetorsAgent TCtIB0l�mvstwov:�eaienero�tonser.:kompwownerb4oacnnmos0��'1 <br /> CONTRACTOR R L�-IA 'lC� f y..t. EC �c,.� L 3I Gc.# RCL. COE Bus. Uc. #3{D�] <br /> nenress '�p '�d Z � v o O Pnone�Email z p(o (o$Z� /ad 3� <br /> TENANT BUSINESS NAME ;ONTACT FOR PERMIT <br /> VG�cGtn+ S GI,Ce. teE���+ r��wA,Z� <br /> Phane�E�man [.� G _ � � � 1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � I I oo,o0 <br /> Existing Use a�Bwiding WA(Z-E (�al S L HEAT SOURCE: <br /> Proposed Use of Building �A��" N°i�$ � Gas �E�ednc Other <br /> Bwldmg type�. _Single Family _Duplez_Townhouse _Mulli-Family _Co�/rrw�eraal <br /> T pe ol pro ect: New _Addrtion Remodel __Repa�!_T.I Siqn 1'S nnkler Demollt�on Chan e ol Use <br /> DESCRIPTIONOFWORK(ada:nona�spaceprowdedonme6ack) -�ELo��Tr /'\ NtAD <br /> �J <br /> -� A,�� � �a E�� �,� E,���y <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: _New_Addn _Altaration_Ropalr Type ol ProJoct: _New_Addn _Alleralion�Repair <br /> Show Number(a)ol listures Show Number(N)ol lirtures <br /> A/C-art handlin units Toilet <br /> Forced air s stems Balhtub <br /> Gas ipm LavaW (wash basin) <br /> Water heater Shower <br /> Gas fue lace Knchen sink 8 d�sposal <br /> Gas ran e Dish�,vasher <br /> Clothes d er Clothes washer <br /> Ran e hood Waler heater <br /> [zhaust lan Smk(servicefbarlmo le�c.) <br /> Heat pum BacAflow revenler <br /> Unit heater Unnal <br /> �oiler Dnnkm Fountam <br /> Refri eratwn Floor dram <br /> Woodstove Grease tra <br /> Ductm Rool drams <br /> Other Medmal Gas <br /> SPRINKLER I SUPPRL•SSION SYSTEM Other. <br /> Number ol Heads Other. <br /> I here0y renify tnai I have reaC aoC e�ammed t�is applirauon and knox t�e same to Oe Ime antl canect All prohsiona ci laws antl ominances governing Ims rype cl wod wdl Fe wmpfred <br /> wn�w�e��er sDeUceO herein or ncl.i�e grdnung ol a OermA tloes nal presume to grve aut0onty to violate o�wncel��e pmvision of any oiher s�aie or locel law regvlabng consimcf�on <br /> T�a�1 am au�hon:eE by ihe orner Nt�is property to pedoim t�¢work lor xhic�appSwLon is maEe a�d I comON����e Slale Confratlois Law 1B2)RCW anC i96 2POA WAC <br /> /N�/L m.r.G�� f/- zb -i 3 <br /> OwnarlAuthorizod Agent Signature Date (Fensetl 6?072) <br />