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� . <br /> PERMIT APPLICATIOEV <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> C1TY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8t3'10 PAX 425-257-�II57 ��nvw.evereftwa.org <br /> APPLICATIONS ARE ACCEPTED PR0111 8 Ah71'O 4 Pht <br /> SITBADDRESS: PRlrC1iNTA 8 P RilIT�! <br /> 2,r � , w�ruuNB �mJ DK. c)o5(. 3 DDoo yoU - S <br /> LEGALfornewconsWciion: ShoilPlullsu6division____ lolNo._ (allacliapyotbnglegaldescripGon) <br /> OWNER ��7�LC `��1 ��s'r PhonMGma:l _ <br /> Adiress ?D, f�,ox I "1 CilylSlatc/Zip C1/aIP.oTT, �,�Jq ?p6 <br /> APPLICANT:' Or�ner O�sn^r'sAgent _CeNrac!er Conlrae�arsAgent TP.09pI(muzipiwkoalNVrofcrosonl6zmU:nex^rrtnCav.ehin!hasp�ce) <br /> CONTRAC7'OR CUEKGftG�N �t�i t�e�rr r�� i.s i ���.r: EvE�2�ss oxzoT coF a���. u�.�;� 0o"1955 <br /> ndd��ss 217A I�AGI�It- 4�U�.EVE{?.�y't-( c,�p 98Zo� PhcnG[m�d L�Zy� ZSZ -31/4 <br /> 'I'ENANT BUSINESS NACdL• CONT C7 POR PERPo7IT � <br /> C'�zS�zs 2-�,u v <br /> �u �J �W Phone/E-mail 1N/1Y� Il.�•C41N <br /> BUILDINGPERMITAPPlICATION CONTRACTPRICEOF�VORK��Do <br /> Fxisting Use of 6uiiding %'�"� FIEAT SOURCE: <br /> Proposed Use of Building �7/4'� Gas 7C., Electriq_ Othec__ <br /> IBuildinc�type: _SingleFamiiy _Dupicx_Townhouse _AAulti�Family _Commercial <br /> Typeofproject: _K_Nee� _,Addifion _Remodel __Repair___.T.i._Si,ryn _ Sprinkler_ Dzmolition_Chango ofUso <br /> L�ESCRIPTIONOFWORK(addifionalspacoprovidedonfheb� ): <br /> �00 n upr�P �no � ��� �`�r�w <br /> MECHAN(CAL PERMIT APPLICATION PLUMQING PERMIT APPLICATION <br /> TypcofProjecb _�New_Addn _Altcralion_Repair TypcoFProjeel: _Nmv_AAdn _Alleralfon_Repair <br /> Shoriilurn6er(;!)o!!ir(ures ShowNurnGerll�)�flix(ures <br /> � NC—airhandlinqunils 1'oilet <br /> � Farr.edairsy,lems Bathtub <br /> __j � ��y.Pi���i� Lavalory(riash basin) <br /> � Walcn c�afer _ Shov�er <br /> �. Gas firr.place I Kitchen sink£disposal <br /> � � Gas rnnqr. � Dishwa,her <br /> � Clolhes dr/er Clolhec�vasher <br /> � Ranqe hood . Water healer <br /> Edi2ust fan Sink(servicrlbarhnop/elc.) <br /> I leat pump � O.,ckllov�prevenler <br /> ��___Unit healer _ Urinal <br /> � L3oiler Drinkinc�Pounlain <br /> � Refriyeialion I'loordr�in <br /> � � WuoJslove Grease li2p <br /> � Ductinq � RooF drains <br /> � OP�=r._ _ Medical Gas <br /> SPRINKLER / SUPPRFSSION SYSTEM a�her <br /> � Numbero(Heads Olhcr: <br /> I licreby rerLfy Ihal I havo read anJ ec�mineJ Ihia app�w�ion and i.nor�Q�o xame lo bn tmn ae�certed.NI piovislons cl Inws anil r.nlinnn�es govemin��ds type olwoik�h:i be u�mp.`.rd <br /> v.ilh whc;hcr cpcuficd MreS�or nol.ihc Gian�'ny al n permif dac;nnl prnsumo In pivc auNm�,y lo vioLdo or e�necl lho p�ovision of any othcr slale or loeal law regnlatinp u`.��uclinn <br /> ❑�al I am:m0�oiized Ly O�c or.ner ol lhis pm0erty to pednrm ihn tvnrk lor w�ir,h app^albn L^made anA 1 rnmply��iA Ilw Slal,�Conlr•iGa�s law I B 27 Rf.N/and 29fiRU0A l/AC. <br /> I - 27-� y �(� <br /> f�»erMull ri� d�gen Si�nal�ne Il;itn. � (Fevisedf✓.'019) <br />