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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SI., Everett, WA 98201 425•257-8810 FAX 425-257-8857 vnwv ev retri�la or � <br /> �-n `� <br /> SITEADDRESS� � e pNOPERTVTAKp �RMITz� <br /> C � <br /> LECAL for new consiruclion. ShOrt PlaVsuOarvision :ol Na (attach cepy of lor9 legal dexnp6on) <br /> OWNER /.Qp� , p�� Pt�ene�E-mai �ey�� Gly� ( �/ .GV <br /> . — / � <br /> Adtlress e Gty�°latc2p ' _ !� <br /> APPLICANT:^Owner _O�.ner'SAgen1 CONrdCIOf COn�fdC10i5AgEni TE^d0�(mutlprc�+Cealrnercl;or:erl�mni�Aocwr<r'oCo+..��o�fo�pa;c� <br /> CONTRACTOR Stale Lic. K City Bus. Lic r! <br /> Add�ess Phone/Emal <br /> TENANT 6USINESS Nq�r7E �ONTACT FOR PERMIT 9.ap,s/•�S SS•�F�IO\ <br /> � �Lf" �/��������( e,� PnonelE•mad � 1 nf�l ��Va�G�J �q• � <br /> BUILDING AERMIT APpLICAT ON � CONTRACT PRICE OF WORK�QhcG � <br /> Exlsbng Use of Bwtding _ HEAT SOURCE�. <br /> Proposed U5'ef Bwltling Gas E�ecinc Other <br /> Bwltl�ng tyce _S�ngle Fam��ty _Duplez TTownhouse _Fdulti-Famtly _r�_mmerral <br /> Tvpe ot pro�ect: _New _Atltl�tion _ Remodel _Repair_T I S�gn S�rin4le: Dzmoid�cn Change cf Use <br /> DES�� �'TIONOFWORK(add�nonalsovicep�ov�d�don;rtenacx�. <br /> I /"�'�/Ft� ti/J Q sj� � , . <br /> / <br /> � •�I r ��. <br /> I ' <br /> � � �. � nr . �. • �n • r. <br /> �11ECHANICAL PERMIT APr�ICATION � PLUMBING FERMIT APPLICATION <br /> _ ��.�' ,. <br /> Type of � iecl: _New_Addn _Allera:ion_Repair .Type ot Project:. YNew Addn • �Alleralion_Repair <br /> ShowNumber(N)ollixfures � � 'ShowNumber(p)o/Ii�luJes • <br /> I NC—air handhng units � Toilet <br /> I Forced air sys�ems � 8a�htub <br /> Gas piping Lavalory (�+ash 6asin) <br /> Water heater � Shower <br /> Gas fireplace � Kdchen sink&disposal <br /> � I Gas range Dishwashcr <br /> I Clothes Aryer G�olhes washer <br /> � Ran9e hood Walen c�aler <br /> � Eahausf lan Sm4 (scrvicdb�dmop/etc) <br /> � Hea�pump � E3ackllow preveNer <br /> � UnA lieale� I Unnal <br /> � OoJer Drinking founlan <br /> I Refngcration � Ptoordrain <br /> Woodstove � Grease trap <br /> Ducting Roof drams � <br /> � Other �Llediwl Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Other <br /> NumbcrofHeads � Olher. <br /> 1�emEy cenAy�pat I�am�caC ana e.am�ned i�is app!�ca9on anG lnmv Ihe same to�e Irue antl co�act A'I pmnsions ol la�.rz and orCnancrs 5o��ern�n3 tA�s qpe ol wo�k xtl Ce campi,etl <br /> wr,n wnel�er spenGCE�ercin or not.Ttie gramlog ol a pe�mJ Eaes nol O�esume lo give aulharrty lo violale or cancel Ihe proeision of any ot�et stale of lowl law regulal�ng mns'mnion <br /> inat I am aulnonzce Cy ine axner ol ihis pm0eny Io petlortn�no�v:�k for xfirt�apDl�'wl�on is maCe any�comply wli�me Slaic Canlractors Law 1B.77 RC W ana Z96 t00�'h'AC. 1�� / <br /> (/ <br /> L � ��� 6/�i <br /> Owner uthnrivndAn tSionalure � Daie lRev�5ed3l101J) <br />