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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/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 <br /> ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: "' PROPERttTA%p PERMITN <br /> ` J �. �1A i � I���J <br /> LEGAL tor new consWclion: Shod PlaUsubdivision Lol No._ (atlach copy ol long legal descripUon) <br /> OWNER J! �� � � Phone/E�mail V � / I��u,�a <br /> Address l �v� � � � V,/� Ciryl5latMZip /� U� <br /> APPLICANT: Owner Owner'sAgent Conlractor _ContractofsAgenl _Tenant�m���v�+besbixroiconsemo-omm.o«+enoaawnmms.paul <br /> CONTRACTOR M 1 ' U W �. l&I Lic.# S j 1.,� C��O�/J COE Bus.Lic.# <br /> Address �pJi� �,�) � IV < �'1AN6 15 W A Phone/Email/�) LG� l.� 0 (N\� Do <br /> TENANT BUSINESS NAME �t�r' � � COf�"I�r. CONTACT FOR PERMIT <br /> f <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> HEAT SOURCE: <br /> Exisling Use of Building <br /> Proposed Use of Building Gas" Eiectnc_ Omer <br /> Building type: _Single Family _Duplex_Townhouse _Multl•Family _Commercial <br /> T pe of pro'ec�: New Addition _Remodel Repair T I Sign Sprinkler_ Demolition Chan e of Use <br /> DESCRIPTION OF WORK(adtlitional space provitled on the back): <br /> �Un� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypaolProJect: _New_Addn _Alleratlon_Repalr TypeofProJecl: _New_Addn _Alteratlon_Repalr <br /> Show Num6er(ll1 o!lixfures Show Num6er(a1 0!Rrtures <br /> AIC—air handlin9 units Toilet <br /> Forced air systems Bathlub <br /> Gas pipin Lavato (wash basin) <br /> Waler healer Shower <br /> Gas freplace Kilchen sink 8 dis osal <br /> � Gas ran e � Oishwasher <br /> Cbthes d er Clothes washer <br /> Ran e hood Waler heater <br /> Exhaust fan I Sink(servir.e/badmop/etc.) <br /> Heal pump Backflow preventer <br /> Unit heatcr Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease lra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> Number of Heads Olher: <br /> I here�y ceniry Ihal l hava read ond ezamined Viia aDPlicaiion antl Anow the snmo to Go Irua ond rnrtect.M provisionf olhws nnd nNinencee Baveminq Ihb rype alwoA w+l be mmpfeE <br /> wnh wTeNer speu'md�erein o�noL T�o 9mnlinp ot u peimil tlam nol p�esumo to B�'e oWhony to Yolala rn cnncel Ne pmhsion ol ony oNu�slalo o�lacal qw�epuWlnp confimtlion <br /> Tnal I am nulhotlzed by I�e owner o1Ub properry to DeNorm Nowo�k lorw�kh oDP�olion if matle ontl I compNwth Iha Slaie Conirecton Law 182T RCW end 798200A WAC. <br /> _��v—� ��/3b �� � <br /> OwnedAulhodzed Agent Slgnaluru <br /> Jate (Revisetl N201T) <br />