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PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL. Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO d PM <br /> SITEADDRESS:�n_/ /5'r � PROPER7YTA%A ��Mi�1z � O�j� <br /> ��u� <br /> IEGAL lor newcon;wction. Shon PlaVsubdrvision_�:.I.� _(,�Fj/t7,5_._Lol Na (attach coDY of long legal desrnption) <br /> OWNER �o(LNE.urtwE N�n/ L,c-C- Phone�E-mad Z - 3��'�jo <br /> AdOre;; p CitylSlatelZ�p (AISL(� �O�Z <br /> APPLICANT:�O+mer O+mer;Agenl Conlraclor ConlraclofsAgen� Tenamir,�ie'�•�a�.��n�.o��o�:emM1o�,meo.�.-ma�w���n�.w«1 <br /> CONTRACTOR Lr /`�t� L&I Lic.It CO[Bus. Lic.!! <br /> Address P�one'[mail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT r',�,.,�33 t�-�d <br /> '1 �/� <br /> PhonNE-ma�l � Q '((yVF }�W�tS• V <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORN <br /> Existing Use of Buiiding ` ._ _ HEAT SOURCE: <br /> Proposed Use ot yBuilding _ Gas___ Eiectr�c___ Other <br /> Building typc. f�Sina!:Family _Ouplea_Townhouse _Multi-F3mily _Commercial <br /> Type of pro ecC New Addilion Remodcl Repair_T.I. Siqn_Sprinkler_Demohllon__Chanpe of Use <br /> DESCRIPTION OF WORK(adddiona�sv��r providrd on the batk�: <br /> Roe h4'n1a.�a+� �t* DyKE►�t� 7" �'�L ' SNo`"'fa� PetesrnL er��c �� Tn-'�t*- <br /> I'.1ECHANICAL PERMIT APPLICATION PLUNiBING PERMIT APPLICATION <br /> Type ol Projech _New_Addn _Alteralion_Repair Type ol Pm�ect: _New Addn _AlMration_Rnpair <br /> Show Numbcr(a)al fixtures Show Number(M)o/liYtures <br /> AIC-air handlin units Toilet <br /> FarceA air s stems Dathlub <br /> Gas pipm Lava�ory(wa5h basin) <br /> Watcr healer Shower <br /> Gas flreplace Kitchen sink 8 disposal <br /> Gas ranqe DiShwastiM <br /> Clolhes dryer Qolhes wasl�er <br /> Ra��ge hood Water healer <br /> [zhaust 13n SinA(Scrvicelbadmop�ciC 1 <br /> Heat pump BackOow preventer <br /> Und heater Urinal <br /> Boilcr Drinkin Fountain <br /> Relri cration Floor drain <br /> WooAslove Grcase Irap <br /> Ducun Roof dralns <br /> Olher Med�cai Gas <br /> SPRINKIER I SUPPRESSION SYSTEM Other <br /> Number ol Heads Other. <br /> I hP .� certiH Ih,�l l nave r d i d e.erm.tl t��s appl¢alon and know Ihe same to be tmu no�carttl All pwv5�ons oi 1 iws anG orUiaincas 9avernmg I�is tyDe o�work w•;I ba com01¢4 <br /> �h w I�wi speYAleJ her.in o oL TPe yranLng ol a pertnll Eces nol presume lo yrve aulhorM to vula:e or�incel tlm pnvrsan ul any eihe�slaln oe loral law�eguUting rons�vclan <br /> hall: naulho•¢e��Yl . rwoil�spraV�Yloperlortnl�ewoiklorwhchaPD�¢albn¢mrtleandlmmplywnht�e4'a;eConvano:sLiw1827RCW.nEZ962004W>C <br /> 17� �, �3 <br /> OwnelAuthodzed enlSigna�ure Date (Revised62G11) <br /> � : ��� <br />