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PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810-FAX 425-257-8857-www.everettwa.or <br /> APPL�CAilON3 ARE ACCEPTED FROM 8 AM TO 4 PM �1 �O `� <br /> SITE ADDRESS: PROPERTYTA%N PERMIT <br /> I�} c�7 l�ur.�z�l�er l�z '_9og 7�v3v/ 9c'v � /Z <br /> LEGAL lor new corntruction: Short PlaVsubdivision Lot No._ (etlach copy o11on91egal descnplion) <br /> OWNER+ 'L'•YrPi J'- lT1�� O5 PhOnPIE-mail �'-�-z�9Z. `'.377J N.i4��� hra+ist2��.4. <br /> Address/�✓1 ,T u�/,+�e�I��"✓ h''„e . aryis�e�erz�P L�.e,-e tF u)i4-/ 9 2�� <br /> CONTRACTOR ^ �nt,' S�1zu� �ne55 L61Lic.• JI'rYILIQCI ���S3 <br /> Address � �� ��N�ss oad G�Ntdrlp S�ZHd Phone/Emeil zjLoU. 'Ja7 ���� <br /> TENANT BU INESS NAME ON FO P 'R IT <br /> ��� Fhone�E-mail `Iz5. z31. �3Q�1 �1•�SI �''�uf}+reil.c. .-. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE Of WORK � �3� ��`' '� <br /> Existing Use of Building Si H �IP r.'ro,� HEAT SOURCE: <br /> Proposed Use of B�uilding S i�'t��e- FT+" � � Gea �Gecttic � Other <br /> Building type: ✓Sing�e Family _Duplex_Townhouse _MuRi-Famity _Cammerciel <br /> Type of projed: _New ✓Addition L Remodel _Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> � <br /> DeSCflpBon of Wofk(edCdional space providedon the bad�: ���7�SJ� �a>pHrp.zt �,.,�th b ed r�••�,, t'��'*� Y r�"`^�� <br /> �zu,�d ry �'��m, Fu I I b�rA r�.•,•,� y � ,rd k'rl-t, P n �, <br /> �d� 2 ca,� att�:ti�d �:rayc�`{-� br-c, � ex , s}-�Ny Lr��,s� . <br /> Have you started workinp without a pertnit7 _YES (/NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Prd�� —New!Addn _Alhratlon_Repelr Typa d Proje�t: _New LAddn _Alh�ation_Repal� <br /> Show Numbar(y olllxtures SMw Numbar(y o/Rxtures <br /> I FVC-airnandlin units � Toilet <br /> I Forced air syslems Q I Ba�htub <br /> I Gas ' 'n I Lavalo wash basin <br /> I I Waler heeter Shower <br /> � Gas fire lace Kitchen sink 8 dis sel <br /> I Gas ran e / I Dishwasher <br /> I Clothes d er I Clothes washer <br />; I Ran e hood I Water heater <br /> Exhausl fan I Sink(service/bar/mo /etc. <br /> I Heat pum I Backflow reventer <br /> I Unit healer I Unnal .. <br /> � Boiler I Drinkin Fauntein . <br /> I Refri eration I Floor drein <br /> I Woodslove I Greasetra <br /> I Ductin Roof dreins - <br /> � Olher � Medicai Gas .. <br /> SPRINKLER 1 SUPPRESSION SYSTEM �i � I other: �}-�;� g;b <br /> � Number of Heads I Other: <br /> I hereby cemty that I have read and ezamined this applicauon and knw+the same to be true and correct.NI provisions of laws end ardinencea governing � � <br /> this type ol v.vrk will be complied�tith whether speafied herein or not.The gren�ng ot a permit dces not presume lo give euthority ta vidate or cancel , , <br /> the povision ol any other state or local law regula6ng constructlon or the peAormance ol construction.That I am authonzed hy lhe owner of this poperty <br /> to pedo the r.ork for vfiich applica0on is made and I comply with Me State Conlractors Ww 78.27 RC\J and 298200 WAC � <br /> . A <br /> .�:�,.e l? l�✓ C�. .Zo. J/ <br /> OwnerlAuthor:zed ApentSignature Dete (Revised?/.0f1) <br /> `�� <br />