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PERMIT APPLICATION <br /> BUILI�INGIMECHANICALIPLUMBING1SiGNISPRIfJKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 w�vw.everellwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: vAOPERiv7A%u , P� �T# � !Q <br /> ,� vl �olzo�o�oou� L z( i -U � <br /> `��O I t�L W E �Ezcr. , tiP• _oiJ <br /> r' S lo�No.�, (aitach coOY ot lo�g legal deScnFP�on) <br /> LEGAL far new ton;iruc;un. Shcrt PiaL'suCdivisiony�T�/t! <br /> ' < �JW Lt�(� Phore�E-ma�iyZs'3�j�'S�✓L'' �Q(,�Cn/eLSiwFHo.rytS�✓ � <br /> OWNER p nJ <br /> aaa��:s Po Rox 1 4.N <br /> c��y s�ai��z�o m:c� GR.c ' a Ro eL <br /> APPLICANT:_ Qmner �jO�x�er'sAgent Conlrac�e� Coniraztor'SNgenl _Tew�lim�sio�-"^+��evo'co�.r:k�.-��-ec.^oi=a..�+��^,*'so�r� <br /> CONIRACTOR C.ORr�62S'fC�'�c N�m�j N6J L�L L81Lic.« ' o2� U 4�v COEBus, Lic.# D'-19I9� <br /> AoCress 7CJ "Ox I�7 Z�� ��YL U- �.1��� •W'� a✓UziZ Phone Ema.l Y�S�-�j�"S��Yi 4 aG%tNt�SF�-'�L C S �; <br /> TENANT BUSINESS NAhtE CONTACT FOR PERMIT�� Lq�t�72r.1[-n <br /> ar,o�e�e�mo� NtS-�i3Y;-SB�i�✓I S}� 'GoRN�2stzNEH�.Hcs.U� <br /> f3U1LDING PERMIT APPLICATION CONTRACT PRICE OF 1YORK <br /> HEATSOURCE�. <br /> Ezisting U5e of Building___ _ __ __— . ---- — <br /> Proposed Usc of Building NL w 5r� -� <br /> Gas_� EIecL•m__ O;he• <br /> GuilCin;C�pa �Singie Family ,_Duplex_Townhouse _blulti�Fomuy __Commercial <br /> Tyeeaf projecC K New _ Addition __Remodel Repair TJ S-cn Sormk�er Demolitlon Ch�nge cf Uso <br /> DESCRIPTION Of WORK jadd.ronal spaae Frovh:od on�he ba�+i�. <br /> �v E l.l� �t=�� �11�(�i `-�-- <br /> M[CHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProjecl: .�New_Addn _A�teroren_Repair TypeolProleci: 5'wNumber(tt)o//ixuoeslion_Fepair <br /> Sha�v Numbcr(#)o(lixfures <br /> � AIC-air handlinq units Toilet <br /> � � Forced air s stems 2 6alhtub <br /> � G�s pipinq Lavatory pvash basin) <br /> N�ater healer 1 Shower <br /> Gas 5replace 1 Kitchen sink 8 disposal <br /> � Gas ran e I � Dishwashcr <br /> � Ctolhes dryer � Clothes washer <br /> � Range hood ` <br /> � � Ezhaust fon Sink(servicclbadmoycicJ <br /> � Heal pump Backflow p�^venter <br /> i I Unit heater � Urinal <br /> Boder Drinking Fountain <br /> Refri eralion Floor drain <br /> Waodstaee Grease trap <br /> ' � DuclinG Roof drains <br /> � O�hcr AtediCal3as <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> � Nurnbcr of Hc:+ds Olher: <br /> ii,.. ..�.,.t'yr�,nit. .�eal.ndcai„ li.�s+�� , , ,.f�c.,..,ln. a'�'oU[�un.�almmr.tAllprovisionsollax3an0or4�nances9avormnglh�stypaolwoMwJlMcon�pn] <br /> n rhN.,bm50ttiLe�lhemxiornol ihogranin9o��aPermit�oesnnlf-�esumelo9rveautnonlyiovola:oo��'ancellheO�ovlsonolanyCt+o�5laloorW[all�wmgul�tingconsimcir.�•i <br /> I na!1 am a�dnoiaotl ey�e onnm ol lhis pmpah la pedorm Ne r.o�k lor wh[h epplcalo^Is ma,]a ana I compy wM1h I�e Slala Coniroclun Law 1B 27 0.CW and 296 200A YJAC <br /> � `�' l� l % 'IL <br /> � - : :�— <br /> ,,,._ ,n.,�.�,�.<<,,:, <br /> Owi�odAulhodzed Agenl Signaturc f <br /> � <br />