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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , Gverett, �VA 98201 425•257-8810 FAX 425-257-8857 vr.v�v.evere�hva org <br /> 3 �I6- <br /> SITEADDRE55: PROPERNTA%u F ��� p <br /> � i-� 2 n�� Li��,/,17- � I 0 -CO <br /> LEGAL lor re.v w��stmcucn Shon PiaVsuCo:vi,�on Lot No_ (atlxh copy ol 1o�91e9a1 de;cnpiicnJ <br /> OWNER��L�' � � ��,� �� , P�o��,E.�,��� 9:{ 9_ <br /> Adaress70 7_ Er7 ,C//Lc U/�'"L/ </< C�rylSlatelZ�P El/�y- � Lf��h <br /> APPLICANT:_Osn2t _O+.n2i5FgBn( �COPI'3C:Ct _CGnl�de,OiSAgCnI _TEnanli-�.;ipa��aa'�cna�cir.��sc•t'::T:rer.-nnea+.m��ema.pn�c) <br /> CONTRACTOR L'�f'CG C�o-:� e . /�'�'g��=� #C�l GC'S � y�/O� c�iy ous ��c a ii',P -/b ��Q� <br /> Aedre:.6�`7 � r/�� /�j�ij'G 'G� �'n r��'d�� K/A F'nonMEmaAj�O—'���''-� C <br /> TENANT BUSINESS NA�dE CON7ACT FOR PERh11T <br /> �C%�G/r/,� ,3�4--rjy�/�7�!'� <br /> pnone�E�mail <br /> BUILOING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> EzlstingUseofBudtl�ng S�/c HEATSOURCE�, <br /> Proposed Use af 8u�.ld�ng ,�� Gas� eicu��c___ o:ner_ <br /> Budding type �Smgle Fam�ly _Duple�_Ta�+nhouse _Muih�Fam'y _Commeraal <br /> T�ce of roecl New Adtl�lion Remodel Re air T i. Si n S rinkler Demoi�tion Chan e ef Use <br /> DESCRIPTION OF WORK(atld r:nai spac^c.rndeed on Inc oacKi <br /> ,��ov� ��r,vTU� J�s�i�'GL s�G//✓fr� ,QFGoC�Y1��Q/O <br /> G�i,nG C; vj--�G�7iE'Gr .�ih,� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypcolProjeel: _New_AUdn _Allcration_Repair TypcolProjetl: _New__Addn _Alteralion_Rep�ir <br /> ShowNumber a)o/(rs(ures ShowNurnbcr(a�o/lixmres <br /> NC-air hand6n um�s Toilet <br /> Forced air s stems Da�hlub <br /> Gas p� �n / Lavato wash bas�n <br /> Walen c�ater Sho�scr <br /> Gas l�re lace KAchen sink 8 tlis osal <br /> Gas ran c � Uishwasher <br /> CloVros dr er Clothes wasner <br /> Ran e hood 4Valer healer <br /> [xhaust fan Q>CI r Sink servicelharlmo !etc. <br /> Heal um I t3ackibw reventer <br /> Un�t nealcr Unnal <br /> Bo�!er Dnnkln Founlain <br /> Refn era6on Floordrain <br /> Woodstove Grease tra <br /> Duclin Roof drains <br /> Other f�7edical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. <br /> Number of Heatls � Olher <br /> I�creCY�ea!y I�at I�ave read ar.d e.am IncG IOis app'it.ibon an0 knaw I�e Samc lo De Uuc anE C irt¢cl.NI proais:ens cl laws dnd Ordinanus go�em�.�g V�IS tyDe ol wo�k w�i Ce wmpl <br /> wLnwnel�crsOccR�eE�erenornot IDegranNngalapermtlEoesnol0�esumelogrveau:�ontyNvio�aleorr�ncell�opmvlsianolanyaNcrsldteatloWllawfe9uldLngcansirtclion <br /> Thaiiamaumo�xeODytPe xnerolNispropeMiopertortnNeworklnrwMcnopGSca�I,a�smaCeanClcom;y��.i�ihu5laieConlaUorsLaw78.d7RCWan019fi700AWAC �I7i <br /> —J�z�--�i� .�-%/� <br /> Owner Aulhorized Agen1 Si9nalure Da�e jFievacd?QG7d) <br />