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�ERMIT APPLICATIO� <br />BUILDINGlMECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-6810 FAX 425-257-8857 www.everetiv+a.org <br />= A'JDRESS: <br />23 0 4{� AJ c.. 5� . <br />TAN p <br />a <br />ror new construcuon� Shod olaUsuDdrvisirnWSCJ-�C.�iL [ A2 � Lot No �(aitach cepy ol long !egai tlesr�d c��) <br />� S��str� (�r�c..�� .� Now��S P�o�P�E.m3,� (4zs1 �i S3 - ZBno <br />7Cress I LO S W rL.Jit/�uT NMI.C_. w� �•� •�-n c. <br />—1 i o o ary�_�,�eiaa z.�142E3�' l�-A . �i�32o q <br />PPLICANT:_Ownor _bnner'sA�erd _Contratlor _C�rlraGo�sAgent _Tenanin�..i,�o.•aeevc.�crm-x,i��r.��ewb�i.�x.��..hc-r,.K.�i <br />V� <br />Slate Lic <br />AnCreu �r�hll� Phcne�Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT �ONN C,1?/� W J4 <br />Fh��e,E.T� � 4Z5 ) 35 0- 4 ooz <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Exislmg Usc ol Bwidmg HeAT SOURCE� <br />Prcpcsed Use of Owltlmg Gas � Elednc CiFe <br />Bw!dmg type� � Single Family _ Duplex _Townhause _ �du4i�Famity _ Commeraal <br />iyoe of pwlecl ✓ New Adtldion Remodel Repair T I Sign Spnnk'er Demo't on Charge of <br />DESCRIPTION OF WORK (ac�rti�nai space prcv�ded en trie back) <br />�dt l 8 1�1�*+�1 Z GAlL Ci AILA��Z.. <br />MECHANICAL PERMIT APPLICATION <br />ol ProJocC �' Nvw_AdCn _Alloolfan _Rapair <br />Show Numbor(a) olltrfures <br />A!C — air hantllm0 Unils <br />� i �oRnd dlf Sy51eRIS <br />L�AIf <br />N SYSTEM <br />ol <br />i — t'. V tOi'7 �P� <br />�a�s� �� ,�� ��I o3, oo'j <br />PLUMBING PERMIT APPLICQTION <br />_AAdn _Allnrallon _Ropalr <br />!-� I Lavatory (wash basir <br />1 � Shower <br />\ i Kdchen sink & dispo<. <br />l �Ji5h1VJ5hCf <br />� � Clothes washcr <br />1 I Water h��atcr <br />_ � � Sink (scrvicelbar;mo{ <br />� Backflew preventer <br />Ufinal <br />Dnnk�nq Fountam <br />� Floor draln <br />� I Grcosc truo <br />M1tedical Gas <br />Olher <br />i nemby cendy mel 1 �avn rtaC and aiam�nM IHa appsn;ron an0 know i�e seme �o Ee tme enJ mnecl A� prov�cwm al inws onC wOmances gaeming Ihls �Po d work eil Oe mmycd <br />mlll h1e1M/ spe�N herem w nct. Tlie glanlinp o� a ocrtli1 d0ef n01 pesume �o y4e aNPm;y ;o � i:.Jale w dncel lna �YovISKK1 d e.'1y o��er pinte o� bGtl lew Mgulalm9 crosin�da'1 <br />Tiwt I �m u!non Gy tn �ner ol lnl oroGerty to pMcrm Ihe HVA Ier nn:n epD.��wi',:n �; mece a�a I eompy wnn rha Slale Cenvadcn Law 1B 2i RCw ena ]?5 2LOA WAC <br />� y <br />—�;�_ 9 - 2C�- r �( � �._ <br />O i dAulhorizrttl AgeN SI �naluro Cale (Rewsed 3?013) <br />