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ti <br /> . �RMIT APPLICATIOI� <br /> BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLER/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 /> a-�'—i <br /> SITE ADDRESS: VNOPERTV TAIf k PE MIT# <br /> /or� M�P� � o �a���i�o��� � -o <br /> LEGAL lor new conslruuion�. Shorl PlaVsubtl�vision lot No_ (�U:::h copy ol iong legai descnption) <br /> OWNER �r1���� N��(�i PhonelE-mai� /ZS'��_/� �32�-- <br /> Adaress I��� �l� `� �� Ciry/S1ale/Zip ��E�i/ (/�/A• r�0�� <br /> APPLICANT: _Owner _Ow�er'sAgenl lJ�Conuactor Comroclor'sAgenl _Tenam�m�;io�o.�co.,mr.��cimos.m��ommoo�n��i000..o•���meaoaca <br /> CONTRACTOR U/U�l�/�� EN�r`� EF'-���f Stale Lic. k SGiN0A6S�c�3�9 c��v e�s. ��c. u 3�sy <br /> naaress %��-� ��lN 5/ FL(. v.�A. �'fg0!/ Pnone�e��ia�i ��-�l'�rdo�1 JIIA//lAn1Q�.IVE �� <br /> TENANT BUSINE55 NAME CONTACT fOR PERMIT /�15�✓• <br /> 6i1-i�e�✓ GE-�— Su��e�F,,,�j, �^^ <br /> PhonelE•matl <br /> BUILDIMG PERMIT APPLICATION CONTRACT PRICE OF WORK (0/�S <br /> Ezishng Use of Bwlding �� HEAT SOURCE�. <br /> Proposed Use of Building �l'�— Gas� E:eUnc Other <br /> Building lype: C Single Family _Duplex_Towohouse _Mulli-Famdy _Commercial <br /> T e of pro�ect New AdCitio emodel Re air TJ. Siqn S riakler Demoldion Chanqe of Use <br /> DESCRIPTIONOFWORKIedv�tiona�spacepro�idedonmebace). W��fJ�- l`���'TE� W�T/7� <br /> �E��,��a,v� Fxi;Ti�� EL.�GTi�-�c, Fv/-,✓�ErE Anid <br /> �vfw G�A� f����E a�d w��rJL- N�A�r�l�- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProjecC _New_Addn _Alteralion_Repair Type o1 Project: _New_Atldn _Alleration_Repair <br /> ShowNumbcr M ol�xtures ShowNuniber a olfixtures <br /> A/C-air handlin units Toilel <br /> Forced air s stems BatLtub <br /> ^ Gas i In Lavalo wash basin <br /> Water healer Shower <br /> Gas hre lace Kdchen sink 8 dis osal <br /> Gas ran e D�shwasher <br /> Clolhes d er Cbthes washer <br /> Ran e hood Waler healer <br /> Ezhaust lan Sink serncelbar/mo letc. <br /> Heat um Backflow oreventer <br /> Unil healer Unnal <br /> Baier Drinkm Founta�n <br /> Refri eration Floor drain <br /> Woodstove Grease Ira <br /> Duchn Roof drains <br /> Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number of Heads Othec <br /> �hereby ce�ily Ihat I have mad and e.ammed Ihis app�tabon an0 know ihe same lo be Irue antl mrteU.All pmvisans af laws and orCin3nce5 go+em�ng t�is ryDe o1wo��+�I Oe comp <br /> wnn whemer spe fed he��.in or no6 The granl;ng of a perm�l tloes nat pmsume to 9�ve aNhonry to vlolate or cancel Ihe provis�on ol any olher slale or locsl law regulaung cunslructio� <br /> Thal I am au�h x I by U !ownci ol ih�is O�oOe�y Ic peAortn 1he work lor wh¢h aOPlsatmn is made and I comNY���h Ihe S�aie ConlraUors Ww 18 27 RCW and 195.700A WAC <br /> '�-'�-1 S <br /> OwnedAut orized g t5ignalurc Date (ReviseA9/7014J <br />