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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org l <br /> � <br /> SITEADDRESS: PROPERNTAXp PERMIT• _ 1�p <br /> u� � Z It �'0 0 <br /> LEGAL lor new consimction: Shoh PlaUsubdivlsion Lot No._ (attach copy ol long Iegai description) <br /> OWNER �� ( � C ,� � ��C` PhonelEmail <br /> Address 4 ` CitylStalelZip P Y � G << � � n <br /> APPLICANT: Owner Owner'sAgent �Coniractor Con�rador'sAgent _1'enanl(m�sipm���ooaimmrotcorsomaommeo.�anaaowoamuwspacal <br /> CONTRACTOR T�. Co.+ C i . L r� c Stale Lic.# i��B « r 9s sKsatY a�5. ���.a <br /> ndaress y2�-y SS���v� NL' lKc.: s..,��t G(� PhonelEmail `/.�S^- 3a7 - 73y.5 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building $ �n c� ��� �� � 'y HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Buildin9 type: �,Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New _Addition _Remodel _Repair_T.I._.Sign_Sprinkler_Oemolition_Change of Use <br /> DESCRIPTION OF W ORK(odditiona�space p.ovided on tr�e back/: n <br /> �4 �cn � � r� �i E1f� r' S �Z��c.cr'� cJ� ���v OuFS ' ScYNPn �Cc�O�' #, C.�t� <br /> �lp��� d `a `+ f��u�v S . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ypooiProJocl: _Naw_Addn _Alturation_Rapair TypootProJect: _New_Addn _Altoration_Ropair <br /> Show Numbcr(p)oI flxfures Show Number(8)01/ixfwes <br /> A/C—air handling units I Toilet <br /> I Forced air systems � Bathlub <br /> i Gas piping � Lavatory(wash basin) <br /> � Water heater I Shower <br /> Gas fireplace I Kilchen sink&disposal <br /> � Gas range ( Dishwasher <br /> Clolhes dryer I Clothes washer <br /> Range hood i Waler heater <br /> � Ezhausl fan I Sink(service/bar/mop/elc.) <br /> � Heat pump I Backflow preventer <br /> I Unit healer i Urinal <br /> - i Boiter I Drinking Fountain <br /> I Refrigera�ion I Floor drain _ <br /> � Woodstove � Grease lrap <br /> Ducting I Roof drains <br /> � Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> � Number of Heads � Other: � <br /> 1 here0y certAy thnt I hevo reatl end examined Ihis application antl Anow the same lo Oe lme ontl correct All pmvisions al laws and oNinances 9oveming Ihis type ol�+rork niil be complied <br /> w�th whot�er specified herein or naL 7�o gmnling ol o pertnil tloes nol D�esumo to give autboriry to violate or wncel Na provision ol any other staie or local law re6m�tmq mnstruclion <br /> That l om ButhOnietl by IOe oNner ol thi4 property lo peda�m lhe work lorwhitl�epDl¢alion is maCe en01 tomply wM the Sta�^Comratlon Law 1B 27 RCW anE 295.YOOA N'AC. <br /> �/,; � � p � ✓�) �/,i 1 /,�C/3 �Revised 3R073) <br /> OwnerlAutho ized Agont Signaturo Date <br />