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� � <br /> . PERMIT APPLI�,l��S�M <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 37_00 Cedar St., Everett, WA 98701 425-257 8810 FAX 425-257-8857 �v�w�.evereth�aa.org <br /> p 3p �! <br /> SITE ADDRESS: Pa0PER7Y7A%s iE$h11Tx� i O - <br /> 'S/S 5� � w c�� �I� L G <br /> � LEGALtornewconstructiore ShortPlxUsabdivisian LotNo._ (allachcopyollonglegalAescnpiion) <br /> �WNER � CO`'e �L .SD�) Phonel[-mail <br /> ndJres� SS/S Jsf :i �•/ ' CAylSlale/7.ip EVCbti '��� "�/'7 �1�0 � <br /> qppLICAfJT: Ouner Owner'sAgenl �CoNraclor Conlracloi'sAr,enl Tenanlim�:�p:m;eo.,:cnrreimm�mrrom��.o�"��rroco�.e,5;nmuspaa�� <br /> CONTPACTOR /U P�S OJ n t7� L S�-a F�o�� Slate Lic. i! Q� � City Bus.Lic.# <br /> namesslSaoS l4 pV� .uE Ma� av;l/ � �� PhonelEmad µRS/S/.�2 -�abo7 <br /> 7ENANi OUF�NE55 NAh7E CONTACT FOR PER�AIT <br /> PhonelE�nia�t fl Y/rQ"'aN'1 7n ✓'S�o� ' 7��D�� <br /> BUILDING PERMIT APPLICATION coNrRACT PRICE oF WORK <br /> Existing Use of Build�•ig HEAT SOURCE'. <br /> ProposcdUseof�uiljing Gas v Electric_ Olher__ <br /> Buddmgtype: �Single Family _Duplex_Townhouse _PA�Iti•Family _Commercial <br /> iype of Dro�ecl: New Adtlition Remodel �lepair_TJ. __Si9n_Sprinkler_Uemolition_Change o(Use <br /> DEnS'CRIPTIONO�WORK fadd�licnolspacoproNAedonlheGack)� <br /> (�CdlZi ��y�!/J%fbr/t,�Ln rra/�S�:�,�%i'G J lk�,� �`�r.v,l�:�,./�f Iym o fr�o ��s.�.r r✓,h6�a.1S <br /> �IECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TyP�ol Projecl: _Nav_Addn _Allerallon�Repair TypoolProjecL• __New_llddn _Alleralion�Repalr <br /> Sho�v IfumGci(HJ ol lix(ures Slrow Num6rr(s)ol lixtures <br /> NC-�air handling uni�s ,j I Toilet <br /> L� — forced air systems �- � UalhWb <br /> � Gas pipin9 I �.evatory(wash basin) <br /> N/aler healer � Sho�vcr <br /> Gas fireFiace Kdchen sink B tlisposal <br /> Gas rangv � Uishwasher <br /> � Clo�hrs dryer _��I Ciothes washer <br /> � Ranyc hnod � Walcn c�atcr <br /> �j � - L=ahaust fan� Sink(scrvicePoadmop/e�c) <br /> Heal purnp � HackOow prevenler <br /> � Unil hcalcr _ � Urinal <br /> 13oiicr Drinking Founlain <br /> � Refrigera�ion Flao�dmm i <br /> � Wwdstovc __ Grcasc Irap <br /> Ouclmg Raof drains <br /> Olhcr Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM � Othcr. <br /> Number of Heads � Olhec <br /> I teneLy ccit�ly Ihai I havu rcaG and enm'�ncA Ih'rs appl callan ar.d tne:i Ilio,nmo lo Lo tn+n and muettl�ll p�ovisinns ol lan�v�ni1 oren�anees�ovemin9 Ihi�Iypn cl woi4 v:!I t:n ro:r'�.i�A <br /> xAM1 x�e;hel specilied Mrein or nol lhu gianlin9 cl��peimA Joes nol prcsume l0 9ivo avtlmnty In vlolale or wncei I�v provision ol any olhel slala or local I�w reyula��ng ce�ntn,c!i;n <br /> TPaI I am a•.i0�ciiaM hy Ihe owne�of Ihb propcity to pc�form I�c woM1.fet whh�i apFOcalien is nia0e and I wmpiy wit�Iho Slale Conlradors Law IB D RCW anG 23G 700r\1:'/.f. <br /> �°7L"`'L«w.�i�.�/rL/! '7'–_ ___ <br /> OwncdAulhorited A9ent Si�nalum Dalc (Rnvisrd J/;p1,31 <br />