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' 1 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www•e/v_erettwa.org <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM V ��O�I � <br /> PROPER7YTAXN p MITtl <br /> 1�� RESS: IP� S'�r�PG'l� �✓C/GC�' qSZO) -D� <br /> LEGALfornewconstruction: ShortPlaVsubdivision LotNo._ (altachcopyoflonglegaldesuiptlon) <br /> OWNER MV1�1 Pi` 0 � � PhonelE•mail L�7� �{ l `Q� I <br /> Address �� ���� ���'l` �� City/S(ate/Zip <br /> APPLICANT:_6�rer _OwnersAgenl �Conlratlot _ContreclorsAgent _Tenanl(mus�wv+'eeaknnWcwsemkanmeo�craEown�xmesoac) <br /> CONTRACTOR {J�X� �S��'rr^��'� �n�' L 81 L(c.# ����5Z6� ��1� COE Bus.Lfc.# II <br /> AdCress 177�/ 1N• Fj6`fCG,�n Q�• W�dG�n�ill� w� °I�� PhonelEmail V{�• ( 1�•O��O <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Q���i�j rjLYr� <br /> �{LS- 'if.L^ $2Z- , <br /> f� A PhonelE•mail w+►�esSO Fenixre otrn'�'��• � <br /> BUILDING PERMIT APPLICATION coNTtu�cT PRicE oF WORK 5�0�p00,pp <br /> Existing Use of Building �e51 <br /> Qy`LG HEAT SOURCE: <br /> Proposed Use of Building r�� �'�' Gas Electdc other <br /> Buildinglypa: XSingleFamily _Duplez_Townhouse _Mulli-Family _,Commercial <br /> T e of ro ecl: New Addilion Remodel Re air T.I. SI n 5 rinkler Demolition Chan e oi Use <br /> DESCRIPTIONOFWORK(additionalspacoprovidodonme6ack): �p�n�Q��, b,�/'f)OIYI 1NI��5� <br /> cc,pa� t F':r� d�,.,,,,�.ye -rd �w,ti.� '_`T �,rw;,� �,1skl� d��a�� <br /> �RN+,�� inS�eGro 1 �fGt�lA.dl�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofP•o�ecl: _New_Addn _Alteration Repair Typ ofProject: 5howeNum6er(N o/flutu'res`i�n_Repair <br /> ShowNum6er(p o/Ilxfures Toilet <br /> AIC-airhandlin units Bathtub <br /> � Forced air s stems Lavato wash basfn <br /> Gas i in <br /> Water healer Shower <br /> — Kitchen sink 8 dis sal <br /> ,as firepiace Dishwasher <br /> ',.•sran e Clolheswasher <br /> �••hes d er er healer <br /> Ra hood <br /> Ezhau fan Sink rvicelbarlmo /etc. <br /> Heat u Backflo reventer <br /> � Unil heater Urinal <br /> 8oiler Orinkin Fount <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Duclin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM other: <br /> Number of Heads Other: <br /> I hereby cerlify Not I have read end exnmined Nia eppficauon end know tha same to ba we end wrtetl.N�Grovisions ollawa end atlNencea Boveming�hla ypa ol work r+A be compfed <br /> with whethar specif�ad herein ar nal Tha granting ol a pertnil dcas no1 precuma ta glva euthoriry lo vblato or cencel ihe pmvisbn of any othm stele or bcal law reguletlng ra�strucfion <br /> Thal am eulha' d by tha owner of Nla propetlY�o peAa�m ihe wwk for whkh appGwlion is made and I eompty Mih the Stete Contracton Law 1B.27 RCW and 296.10UA WAC. <br /> --- tib IZ <br /> OwnerlAuthorizeA Agaa 5 gnatu e/ <br /> Date (Revised 6/20f1J <br />