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PERMIT APPLICATION <br /> BUtLDING/MECHANICALIPLUM6lNG/SIGNISPRINKLER/DEMOL.ITION <br /> CITY OF EVERETT PERMIT SERVICFS <br /> 3200 Cedar Sl., Everett, WA 98201 425-257-8810 FAX 425-257-8857 �wwv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: yt. �ROPERNTAX#OI IOIZUOOIGO �R(Z� —OI 1 <br /> �9�5 I P� W E =r V� u/ ' <br /> LEGALfornewconsWctirn: ShonPlaOsubdivision �ST'1 L=(�f�� LotNa� (altac�coCyof�onglegaldescnption) <br /> OWNER �p r� /JtAJ L�-L Pr.one�E-ma� N�S-33u'Sf3vQl �� ��-�1e25n:vFNc tS.0 � <br /> ndaress Pp o / 4 y c�ryiscaie�za Ititrac. G?-t ' A ➢D SZ <br /> APPUCANT: Owner �Oaner'sAgent Coniractor Conlrac:ofSAger.t Tenanli��ac,c.�aoaicere�u�ser:eo��vec.-enam.on„r�sca;m <br /> CON7RACTOR �.ORrJeRS'ft�dE {�-�m�S Nln1 LLL L81Lic.# oR� N 4?G COEBus. Lic.# D�IqI97 <br /> rlddress �p (�oX iy Z�I �1;r��C��1< ,W�a 9�u4;Z Phone;Emad �Zs-?i��S�L'C� � G�zN��sx�e � cs �, <br /> TENANT BUSINE55 NAME CONTACT FOR PERM1IIT�� �Q�,y��2N�"J <br /> PhonelE-mail NZy•7� V-S,°�Q�/S�F Ca�N�;2zhrlEt��M[S.� <br /> BUILDING PERMIT APPUCATION CONrRtiCi PaICe oF woRK <br /> ExistingUseoBuilding_____ __-- HEATSOURCE: <br /> PreposeCUseof6uilding VEW �ifQ Ga,_�. E�ec;ri__ O;her__ <br /> 6uildingtype: �SingleFamily _Duplex_Townhouse _hlulti-Family _Commercial <br /> Type of project ,\_New __,ACdilian ___Remodel _ReD�ir__T.I. _SI9n__Sprinkler___Dert�.olition_ Chance of Use <br /> DESCRIPTION OF WORK(ado�ocna�spacc proviCed on thc back): <br /> �vE� s��� I�As�- �- � � °1 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APF'LICATION <br /> Type of Pro�ect �New_Addn _Alluration_Repoir Type o(ProjecC �New_Addn _Alleration_Repal� <br /> Show Numbw(dJ oI Iixtures Show Numbcr(aJ ol Rxfures <br /> qIC—airhandlin units Toilet <br /> � � Forced air systems 2 Balhtub <br /> Gas piping Lavatory(wash basin) <br /> Water healer 1 Sh�v;er <br /> Gas Greplace I Kitchen sink 8 disposa� <br /> � Gas ranqe I Dishwasher <br /> � Clothes dryer I Clothes washcr <br /> � Rangc hood <br /> j Exhausl fan Sink(servicelbadmopletc.) <br /> Hcat pump Backflow pr�venlar <br /> Unil heater Urinal <br /> � 8oiler Drinking Founlain <br /> Refrigcralion Floor drain <br /> � Woodstove Greasetrap <br /> � � Ducting Rooldrains <br /> � OUier__ MMical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> � Numbcr of Heids � Othar: <br /> I Pzre�y cer;,'y Ihal I havr rna]ind e+amu�ed 1'��s app'�ca W n a�J lnow I'���snn•,n lo Da tma n�a corte.� All Crovlsionx ol iaMs an0 orCrtunca,yoveminq Ilils typa d•'n�M n�,l M:mmp�rA <br /> x!hwI1CI110lSOa��re4h0�Omflf101 Thu9�p�tIMIQGI.IpMinA�O051�BIp�C5urt10IO��vO�uIMf11y10vOIdIO�fCdOfCI��OplOVi54�O�d0Y0111M5�0�BOf'�JtdlldwlC[Ju']I',��[OnS:NL:e'.� <br /> 1 ivii�am awnorizeA Gy �o owrer ul Ihis proDertY�o parlo•m�he�w�k lor whch appiKatun rs ma�a anU I compiy wd�Ine Slam Conlractors law 1017 RCYI and 296".GOA\9AC <br /> i <br /> ! � .�'� I � 1% l � <br /> O�v�erlAulMo Ized Agont SignaWro i Dite (Reelse�i n'20721 ,�,� <br />