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PERMIT APPLICATIO� ��, CZ , C.3 <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> � ,�-'17�1G� <br /> SITE AGDRESS: vROPEHTv Tnx q P�MIi D <br /> �0 3'�Ad� SE— �(/F,� � 05��o zoi2 0/000 , <br /> LEGAL lor new consWction�. Short PlaVsubaivision Lot No. _ (aitach copy of long legai descnplion) <br /> OWNER Ey���� QU.����v (� // / � P�one/E-maii Jz�(.r� _ L Z <br /> nddress 3�0 / �L�7 rl�� � Ciry/State2ip �/����r <br /> APPLICANT.�Owner _OwnersAgent _Contnclor _CONnctorsAgenl _TenaN�m�siPma.eoeror.erortmsPmr.ommew.reri000.oninmeap�u� <br /> CONTRACTOR Stale Lic.# Cit 6us.Lic.H <br /> Adaress PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT�Q� NF�C'�C" <br /> PnanelE-mail 7Zsr0� 6✓�/� k'o,�/N@EU/'�I• o.Q6 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK .3S J�• � <br /> Existiny Use o(Building H�FJ1T SOURC[: � <br /> Proposed Use of bui�ding Gas [icdric '� OOier <br /> Builtling lype: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of pro�eU� New Addition ✓Remodel �Repair_T.I. _Sign__Sprinkier_Demolition__Changc al Use <br /> DESCRIPTION OF WORK(adtl�fional space providedon the oack)' <br /> 5�/.O/Nc� � F�A/i'JE"O �v��NANG <br /> MECHANICAL PERMIT APPIICATION PLUMBING PERMIT APPLICATION <br /> Typo oi ProJoct: _Now_Addn _AlloraHon_Ropalr Typo ai Projoct: _Now_Addn _Al1em11on_Ropair <br /> Show Numbcr�q)o!Iixfures Show Numbcr(N)of/i+fums <br /> NC—air handling unils ToiIM <br /> Forced air systems � �ath�ub <br /> Gas piping Lavalory(wash basin) <br /> � Water healer Shower <br /> Gas fireplate � K�tchen sink 8 disposal <br /> I Gas range Dishwasher <br /> CloOms drycr Clolhes washer <br /> Rangc hood Watcn c�atcr <br /> Ezhaust fan Sink(servirclbadmoplelcJ <br /> Ilcal pump Hachflow preveNcr <br /> Und heater Urinal <br /> Doiler Drinking Founlain <br /> � Refrigcralion Plaor dr�in <br /> Woodslove Grease Irap <br /> Duchng Roof drains <br /> Olhcr Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM olner: <br /> Numbcr ol Heatls � Olher. <br /> I herel�y cerlAy ihal 1 ham rcad nnC e�amined Ihis applieilion nnd Anow I�a same to Ee Imo antl conM.AO piorsion�ol lawa nnd on6wnces govem�n91his type ol woiA will be mmpLrA <br /> w�t�wt�ctl�r�sryrcdreJ lieirin or not T�e giaming ol a pc�mn docz nol pm;umc lo grve aN�onty to vloiale or r.inccl ihe pwvi;ion ol any otner stato or laal law regulalin9 woelvdi�n <br /> lnal I am.ut uecAby�nc ownci ot lh�s proyeny lo perfo�m�ho work for wt+ich appircation B madc unJ I wmpry w�10 t�c Slala Conli¢c�ors I�a 1B 2/PCW nn0 796 700A WAC. <br /> �l�_ . <br /> y-/s=// <br /> OwnedAu� ri dAgant5lynaluro Dale ' (Revrsntl.b701J) <br /> ' <br />