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PERMIT APPLICATION <br /> BUILDING/MECNANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425•257-8810 FAX 425-257-8d57 wvuw.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: PNOPERTV7A%p ERM p <br /> 03�Z �ST 2 S= �� `�- 000 -ci ' - oz p - - C:�r}- <br /> /��� <br /> LEGAI.br new consimciion Shcrt PlaUsubtlivision W� �2�'� '0�'(YJ� Lot No._ (attach copy ot long legal Oeso�ption) <br /> OWNER Ll.'J �Udi�J Phone�E�mail y2� ' Z�� •��S-r!� <br /> Add��ss '7E r l(�-n� ,2 ���Y,s�a��,��P 4nu'�«.Tc� �,'� 43�z7 S <br /> APPLICANT:_Ovmer Owner'sAgenl �Contraaor Conlrador'sAgent Tenantlm��s�o�o.Meakrroim�,e���ro�.•ac+.+�a��ao,.on��,me�oa:e1 <br /> CONTRACTOR L��`L-LMl') L �r'�'��=5 �✓�C L 8 I Lic.# L/11[l:C, i UO�� L COE Bus.Lit.# <br /> Atltlress �G"M1 � � C � ��(C�i_7�S N'1 �1y�5 �no�iMEmail Z) ��7�L'7 ��r� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT S-TGU� W I�Iv�F��S <br /> P�onNE-m3il �12��� J�- '��`' 7 <br /> BUILDING PERMlT APPLICATION CONTRACT PRICE OF WORK I SG If <br /> Ezisting Use ot Building HEAT SOURCE: <br /> Pmposed Use of Building_ �� `1 �� �`�- Gas Eiectnc omer <br /> Building type: �Single Family _Duptez_Townhouse _Mulli-Family _Commercial <br /> T pe of pro'ecl: New Addition _Remodel Repair_T.I. Si n Sprinkler_Demolition Chan e of Use <br /> DESCRIPTION OF WORK�adaaiona�space pmvmeo on me back): <br /> �'`��� �- '4 Z� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol ProJecL• �New_AJdn _Allerallon_Repair Type ol ProJecL• _New_Addn _Alteralion_Repair <br /> Show Number(KJ oflixtmes Show Num7er(P)af lir(ures <br /> A,'C—air handling units I Toilet <br /> ( I Forced air systems I Bathtub � - <br /> � Gas pipin Lavalory(wash basin� �� � �' <br /> • I W�terheater Shower <br /> � I Gas firep�ace Kdchen sink d disposal <br /> Gas ran e � Dishwasher <br /> Clothes dryer Clothes washer <br /> 1 Range hood d' � Water healer <br /> Ezhaust fan t I Sink service/barlmople�c) <br /> � Heal pump I Ba:ktlow preventer <br /> � Unit hcater ! t4ir�al <br /> � Boiler I Drinkin Pountain <br /> Refriyeration I Ploor drain <br /> Woodstovc � Groa�e Irap <br /> I Duclin � Roof drains <br /> � Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other <br /> I M1err.py catAy itial I tiave waJ u��.�c�awin�J'.h��s:ippima'-�m and Ano'.v ipe sam[lo ba�nm und aortecL Atl pmnsione ol lawe ana oranpn[m BovemnB Nlf typo of v�ah.r�l be complled <br /> `� PNICA�CIIICISpCG(iC11hClCiOOI�1CI111C9�0����I�80�dpCR111140CfI1CIQfCSurtIC10QiVL•dulllO�C/IOVI418100ICd9CfI111Cpf0':iSi0I10�dfly'���Cf5IdI00lIOCHI18WfPAl1�d1109C0'ISINCIiJf1 <br /> �inl l am nut�onzeE C��I+o owner ollhie pmperry lo perlortn Iho wod IoneFmh apPlication b maao en01 eomp`/wih lho Slate Contmclare Lew 18 77 RCW entl 2992WA WnC. <br /> �`' l �� -2�-I Z. 1r <br /> OvmcrlAulhorired�qnnt 9na[urc � �� ���� (Rerise�6R011f I 7 <br />