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� ! <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGlSIGN/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 /> �s �l <br /> SIT DDRESS: c�/ p PROPCRIY TAX u P r�'T� �—ODZ <br /> L,��O J lQ i � BGGt Gt.�r c�. GiJPV'eTt <br /> LEGA�fo�new constructmn Shoh FiaUsuhdivs��on Lot No_ (atlac�copy o�long ie5�l Qesc�ption) <br /> OWNER (�ll' 4<P �<<S�f' "-'4NG�aZ2� �C���( f' U PhonelE�mai .?�- 979-Q.�TD _ <br /> aaa�ess ��-�� �G�/eC1 .�'• Si+ �o�.,s a�yisiaeen�e Ss,o�-eror�c�1 Ctl� _ -,��5>>4'� <br /> APPUCANT: _y_uwner OvmersAgeni ConuaUor Contrac!oYst�genl _Tenant,�..:�c�n�a�a�e�:e�oiw�:e��i��cm;^eo..�e���e�wn•���r�:;::��i <br /> CONTRACTOR Sc� �Pii'�o V GZ�[/' SFr�,CC LLC. Statz L�c. # Cdy Bus Lic # <br /> hCdre55 �.�J ��S J�• _ ✓� J-G1�/r�/ �IY-�$ Phonc�Ema�l /�J '"�� ��J � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ruc� Cv�S � <br /> PhonriE�mail �O�_� ���S �D <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK�9�O <br /> Ex�stm� Use of E3wltlmg vG�S , _ HEAT SOURC[ <br /> �' Gas� [leclnc Olher <br /> ProGosed Use o`6uilding � ��J — '— — <br /> BuJdmg type ✓Sicgle famay _Duplex _Townhou e _t7uhi�Famity _Ccmmercial <br /> Type of pre�ect New _llddi'ion _ Remotlel �Repair__.T I. _ S��gn._Sormkler_Demolition _Change ol Use <br /> DESCRIPTION OF WORK ladc�ncnar spaceprc:ieeo on ttie tacw� <br /> C e �a v e✓'"� "�'o �45 /1�e-f— <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Projecl: _New_Atldn _Alleration_Repair Type ol Projoct: _v�:w_Adtln _Allaratimi_ftopair <br /> Show Number(M)o!Or(ures Sbc v Number(a)o!/ixfures <br /> NC -air rantllir.g unds I Toi'�el <br /> / I Forced au syslems � F3alht�b <br /> i Gds O�p�ng L:+valory(wash ba5�n) <br /> water healer I 5ho�,ver <br /> Gas Lreplace i Kilchen sink 8 msposal <br /> I Gas rat�gc U�shv+asher <br /> Clothes drycr I C�o:hes washer _ <br /> ' Range hood ' n e <br /> � Fzhaust lan � Sink(servicelbarlmoplelc) <br /> � lieat Uump � Backtlow preventcr <br /> . � Und hcate� _ Unn�l <br /> � �oJcr I Drmkmg Founlain <br /> � Reln9eraUun � Flo�r drain <br /> � Wooastove I Grease vap <br /> Duct�ng I Rool drams <br /> Other.._ __ <br /> i Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM_ I Other <br /> I Number o!Heads � Olher. <br /> IOercC/r^nAye�allna�ereaEdndr�an'n��0lMzappAcaLonantl�nowltesameloEeiruenrdWrred Allprovrsionso��dwsunUortlmoncesgovemmg1041YDeolwotMn;lecco��ip'rC <br /> xA�nlcl4e�sGeufcO�rreinoi not T�e nr: �I n7 c�d pe:m:t Cees ncl pc;uTe�o?+e a.f�n�r;ly lo uo'd:c er ear�rH�e C�o.izian ul any Clh[r slale o•Io�ii la•v�eg��dl�ng cons�'L[;�nn <br /> i'tJl I am dWho'iiL`d CY IIIPor�le!o11�i5 G�rPi�9�b Cu^C�m IqC�nY��lo e^.c�J:i.'�:a4C^rt.�nade.'d I cempt�K.',�t9C$Id'e COp•,d['crs Lda �n 77 FC::.`^.'.i96:7JA:":,:C <br /> ��r , <br /> OwnedAui o zed A9ent Signature Uatc (Remsetl J?Ot.?' <br />