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, 2t� i��-� Fr <br /> � PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO�PM <br /> SITEADDRESS: PRDPERiY A%11 ��T• 2 <br /> �, � � �� Zr� �� yi, c< vzt`I�1ooc���,4�� -Ol <br /> LEGAL for nea constnictan: Slart Putlsuhtlivisim Lot No._ (at1eU mq o�long lepal tlesviption) <br /> OWNER ���1��� I � <br /> P�ma�E-mail 2�- ? `�7 - 3 Z G " <br /> � <br /> dEr_+ss �� L � ''� �,^ S IS- Gry/5Wte2ip �JC/..�-`�- i�.t�{ r ✓.;✓ y <br /> APPLICANT: Ox+ter Ow�efsAgent _CmlraUor ContradofsAgent 7enanitm+arR�.b..�«dm^���^^�k�^iv1a0oia^^n.w.�� <br /> CONTRACTOR �N �..�f �Y rf C..L, !'�M G„� '1.. 't . �3..L <br /> ) L 8 I Lic.8 � 'l' f. i c:0[Bus.Lit.N <br /> dAress � L f O j ,t� 1� L� � Y > r (',L�:,� PhondEmail 4 L`s • Y •:�,� ' 7 I Z-✓' <br /> T NANT BUSIN S NA E CONTACT F R PERMIT /� <br /> �� �/i..�lh �4.� � �'��/L� ..J <br /> PhonrlEmaii�L � ./ <br /> BUILDIN�i PERMIT APPLICATION CONttucr PRICE oF woRK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use oYl Buildirrg Gas Electnc aher <br /> Buibinq typa: L Single Family _Duplex_Townliouse _Mulli-Famiy _Commercial <br /> T o1 ' d: New Adtlilion Remodel Re air 7.1. Si n 5 nnkler Demo�ition Cha e of Use <br /> DESCRIPTIONOFWORK(ade�ana�speceprovieedonme ): <br /> � � <br /> � i� �i �, '�,t� <j �� �� > ti ) _�,'n4C� C'�tiG�S� <br /> ��,: J .� <br /> liv I , �\ C\ S'�"�`� Sl_ <br /> MECHANICAL PERMIT APPLICATION PLUMBIHG PERMIT APPLICATION <br /> Typp u�pro�et(: -New_Atldn _Alteratlon_Repalr Type M ProJecl: _New_Addn _AltenHon_Repalr <br /> Shaw Num6w(�)o!firhnes Sfrow Num6er(M)ol flr[ues <br /> A/C-airhantllin i�nits Toilet <br /> Forced air s slems Balhtub <br /> Gas i in Lavato (wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink 8 dis sal <br /> Gas ran e Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhausl tan Sink(serviceA�arlmo /etc. <br /> Heat um BackOav revenler <br /> Unil heater Urinal <br /> Boiler Onnkin Fountain <br /> Reingeration Floor drain <br /> Woodsiove Grease Ira <br /> Duc�in Roof drains <br /> Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number af Heads ���� <br /> I�em�y centty Ma�I Mve rtoE an0 eumk�eA Ne applirenon eM k�ww me seme to Ge bua a�W wrtetl.A1 qovsnns ol Nws aM oraneMes go.em.q pirt rype oi v.orA wi�e wmpFM <br /> wil�Mhettrer speoTrcE�ereh or nol TTe Branin0 0l e pertnli Eaos�al presurtre m B�'auNaay la vokb a an�xl tM pmvaion ol eny oUror slate w b�'al law�epuqtinp conswcLon <br /> l�at 1 em euNa{�eJ by 1M mmer ol Me O�VeM�o perlorm me roM1 tw r.�q�eOP�h^^m^��e�I mmOM���e SUIe Conbecbn lew 1037 RC W enC 296200A WAC. <br /> /�' ,/ �tj., Gl. o l�'"�Z <br /> 1 <br /> OwnerlAuthorlred Agont Signatum Date (Revise08201� <br />