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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLEF�IDE�IOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, W A 98201 425-257-8810 FAX 425-257•8857 �wvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 Ah1 TO 4 PM <br /> SITEADDRESS: y+ PROPER7' TA%p RMI # � _ <br /> yaiz I p� w E� - �-- � '➢, ul OI �olZ�oolooc v � �� <br /> LEGAL icr newcon;irucbon�. Short PiaL'subdrvision T LS �{I S Lol No.Z Z (�pac�copy of lonq legal descripVon) <br /> OWNER ,p pJ /Jy�J LV�—� Phoro�E-mai "�ZS-33�'S��QJ �@ �'r1EZ5TUVFko CS�� � <br /> Addres, �p �7,L- <br /> / � y c�iy;s�ai�'z��o M:�� G� A a8Z <br /> APPLICANT: O�.ne� ��ner'srtgent _Co�lracror ConlraclorsAger,( _Tenanl��.sio�=����a�e-��crzo-.:e-:i�����'*�+^�e'�=--w""^��+>a:e� <br /> CONTRACTOR LGR�6RS'TZ✓`�E {�omF NI,� LLL LBILic.k 'o2/� v 47D COEBus. Lic.# D�Iq197 <br /> 4edre=. j U (�,GX ��l Z�I %rtr l.� C�F..L1< , �J fl �✓v�'�— Phone Ema l ','Z S'-33b'S�4� �"dC�tNe+sxti� Na cS �, <br /> 7ENAN7�BUSINESS NAME CONTACT FOR PERh11T�� �A��=�;`„f <br /> Fhone.'E-maIN.7'�i"'V_s��w/�} Go�'NaRiTa%Eft'�MCi.I� <br /> DUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � <br /> Ea�s;in�Use cf Buliding_ _ HEAT SOURCE: <br /> PrcF����Use cf Eaildi y VEN1 sFIZ _ Gi;_1 E:ecL•io___ O;her___ <br /> 6ui'Crig type� �Single Family _Oupiea_ToH•nhouso _Multi-Family _Commera�l <br /> Type of crcject: " New _ Addition _ Remodel Repair T.L SiGn_Sorinker_ _ Oemohtion___Char.ce o`Us^_ <br /> OESCRIPTION OF WORK(aC;l.�nona�sn��e prov�ded an�ne back): <br /> ��El,�l ��I� �`7��J I� �2- I <br /> MECHANICAL PERh1iT APPLICATION PLUMBING PERMIT APPLICATION <br /> iype of ProjecC �Now_Addn _Nterallon_Repair T��pe of Pro;ect: �New_Addn _Alteratlon_Repa�r <br /> Show Number(Y�oIlixtures Show Nun�ber(C)ollixtures <br /> NC—air handlinq u�i�s Toilel <br /> I <br /> Porced air s stems ?— BaLhtub <br /> Gas pipin Lavatory(wash basin) <br /> � Water heater 1 � Sho�ver <br /> Gas fireplace I Kitchen sink&disposal <br /> � Gas ron e I Dishv+asher <br /> � Ciot��es dryer Ciothes washer <br /> � Ranr.^.hood •• e� <br /> � Exhaust fon Slnk�servicelhadmupletc.l <br /> Heat pum Backflow prevenler <br /> Unit heater Urinal <br /> Boilcr Orinking Founlain <br /> Refriqeratinn Flcor drain <br /> WooAstove � Grease lrap <br /> � � Ducting Rool drains <br /> � Othcr Aledical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM otner: <br /> � Numbor o(Heads Olher: <br /> It.rn::qrr•!,ylhatlha+�rendnn�raa;nlredlM1isnpp'e.iWn.andAnnwVwsa�nelolmin�oandcorzn_I A9Dro.is�onvellnwsan��rainarcrsgmerninglhlslype0lwaNwnlb:rom.l..f <br /> v �..���. speul�0�horem cr nol Tlnr 9rd��lmp o1 a penntl 4005 no1 pre5v�'���to p�va aulno�Ay to�rt9a:o or Cnnccl lhe provisNn ol any olhor s:a�e or bCal bw reguldLng Wnstn¢tan <br /> 1 t���i�am aulho�¢eC�y11�a owner o11Ns pm�rnv�,eed,:im ibn w�o�A lor wpcn apV�kalun is maao anC I compy wit�Ine 9ate Gontratlors Law 1817 RCW a^d Y96 200A WAC <br /> � � � <br /> �� �, ;;� � �I,��,�- l� <br /> Own��dAuthodzad Agenl Slqnalurc Da'e (Recised&IG7?I <br />