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From: 12/" l2012 10:58 r145 P.003/005 <br /> ' � i � � v � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320G Cedar St , Everett, WA 98201 425-257-8810 FAX 425•257-8657 wwv� everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM I��lI `I�� <br /> SITE ADDR[55:, PROPEPTY TA%A M <br /> i'�o�l Roc.l<� :� e I$vE <br /> LEGAL lor n:w ccnsirud�on�. Sno�f Plallsubtivimon �ot No. �atlach ccpy ol Iong IcBa�tluscnpli�n) <br /> OWNEIi 1�� n S Pho�elE�meil � � � � - b q �'b <br /> :,ac�ess � Y �Q cav,s�a���z�o �VEZS'L'`}'{' <br /> APPLICANT: OMner OwneYsAgenl �Conlmctor Conlrattor�.Agen� Tenanilm»�o�•�u..�.�u�or<mwmue.nneo.�.�roea..c.�nnw.n.ce� <br /> CONiRACTOR � .7�� �'C.r✓ Q.c� L fl I Lic #� S��W\\��' ,Qi��-COE Bus.Lit.# "�7.5 <br /> naaress 12�eo1 13Z P_ 1�� `ll ' c'a(1c�1 �1� �'�3�'" �'honMEmal ml � c —tlS�-LJ(l�-C�1Pci�-(,C�. � <br /> TENANT DUSINESS NAME CONTACT FOR PERMIT ���;� �t A�l ' <br /> U25 �tx3-1 <br /> PhOnelE�mail �("y�� � �1 f, .L(�jf✓l <br /> BUILDING PERMIT APPLiCAT10N CONTRACT PRICE OF WORK_, 1,�j O <br /> Eaisting Us�3 of Builtling_ HEAT SOURCE: <br /> Proposetl Use of Building Gas Eleanc Olher__ <br /> Ouilding ty;-e: �Single Fmnily _Ouplea_Townhouse _MWt�-Famiiy ____Commerciol <br /> Type of pro ecC New Atldilion _ Remotlel Repair T.t. Sign__Sprinkler__Demohtion____Chanae ol Use <br /> DESCRIPTION OF WORK(aeaaionni spnco pmwdod on mc eeca�: <br /> ��..t�yi�o v� ���� \0.Q� �LLO iN a..�e� �lP�t.Q-�'� <br /> MECHANICAL PERMIT APPLICATION PLUR7BING PERMIT APPLICATION <br /> Typo ol Pro�ecC _New_AdJn _AltaraUon_RCpalr Typo ol ProJecC _Now_�dCn _AlMration_Repair <br /> Shmv Numbcr(kJ nf/i�N�es Show Number(MJ ollixNres <br /> A/C—airhantllin units Toilel <br /> Forced a��r s stems Bathtub <br /> Gas pipinq ' Lavatory(wash ba5in� <br /> � wutm I�ealcr Showe� <br /> � Gas frteplaco ' Kitchen sinK 6 dis osal <br /> Gas ren e Dishwashor <br /> Clolhes tlrvor Clothes washet <br /> Ran o hootl Water heater <br /> [xhausl tan Sink(serviceltar/mopfetc.) <br /> � Heat pump Backllow preventer <br /> Umt hoater Urinal <br /> �oilcr �rmkinq Pount�in <br /> Rclnqmalion � Floor drain <br /> WooAstove � Grease trap <br /> ' DucGn ' Reof tlrnins <br /> Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Otner. <br /> Number of Heads Other <br /> i burocy wrtRy Ipal I I�nvo radtl nnC oaxmnoC IM16 aDi�e�LCn an0 1 nuw t�c�xme to Lo Iniu neE<mre:l AI pmcmns el laws uv0 oNi�ar�os O��emnp Ih�.�'ypo ol wui a-:!Ge ca�n[uetl <br /> mll�whul�ef fptt�9eE�erM w noL Tlio qraMinp ol e pennil tlocf nol prefwne lo p,vr nutl�w ry�o J•oi�le o�c�arel V�e pmvifun ol an�olher Tnlo c�bcei�aw rnp�'.ePrg���sln,;Lvn <br /> innl I em auNorl•���Y t�e ovmar ol l�i�OrypertY lo yetlonn ICe xcA IonMcn nUClcxiin�u nmae arJ i:crrl��y��':�I�e S�ola Cumia.t v¢t ow Li±�HCIv nv_i0G]LiIA vJnC <br /> '' �__ _l�l � " <br /> � � 1 ul'iorl:etlAU���l5lgnalure Il�lo (Re'raeJti/"OfT, <br /> � <br />