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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Ceclar SL, Everett, WA 98201 425-257-8810 FAX 425-257-8857 w�.vw evereltwa.org <br />' APPULATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRE55:� PqOPERTYTA%M ERM 0 <br /> zv � u � 42 oo9oOlo/ I 0 - <br /> IEGAL for new consWaion� Snort PlaUsuotliws�on Lot No o� �anacn coov ol iong Iegai aesrnOhon) <br /> OWNER �QL�..� ,� c��5 TCA\� PhonME-mail �z�(l�-2�{Z �` �Q ��7�Cd <br /> naaress 1�-' - NE Ciry/SlalelZip (,�f SV� l� (�.a= q � <br /> ArPUCANT:Y.OM*ier OwnehAgenl ConUactor ConVaCofsAgent Tenam�R„vom.aceknc�a�u.,rrca mew�.b�ioao.m�.�meew�l <br /> CONTRACTOR 1tQ�C. D t'�, ��QS L 8 I Lic.tl N4�ck Y zo� Z COE Bus. Lic.# <br /> noo�ess 3 9 LZ l�'�` � NC' �i�� PnonrlEmail 42s-z9o-z.yz9 <br /> TENANT BUSINESS NAME CONTACT�FOR PE�TR 0.C� J��@�q��b � <br /> T <br /> PhonrJE mail � —Z.9�— Z � �?M <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exisling Use o(Building �FR HEAT SOURCE: <br /> Pro�.�sed Use of Bunding ��� • Gas_ Eiecnc_ Other_ <br /> Building rype: _Single Family _Duplex_Tmvnhouse _Multi-Famity _Commercial <br /> T ot roecl� New Addilion Remodel Re air TJ. Si n 5 nnkler Demolition Chan e ofUse <br /> DESCRIPTION OF WORK(adCrtionai spece pmvided on me bacx): <br /> bew�o, eX �s+,`hY s �-� q8� c� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoolProject: _New_Addn _Al�eretion_Repalr TypeolProj¢ct: _New_Addn _Atteretion_Repalr <br /> SAow NumDer(p)ol firfures SAaw Number(o)o/fixtures <br /> I AIC—air handlin umts Toikl <br /> Forced art s slems Bathtub <br /> Gas i in Lavaro (wash basin <br /> Water heater Shower <br /> � Gas fire lace Kitchen sink 8 tlis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Enhaust fan Smk semcdbadmo /etc. <br /> Heat um BaUcBow reventer <br /> Um1 heater Urinal <br /> Boiler Drinkin Fountam <br /> Refn eralion Floordram <br /> Woodslove Grease tra _ <br /> Ductin Roof dreins <br /> Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM other: <br /> Number of Heads Other <br /> I�ereby ce�M�al I�ave maa anC ec�m�nM Mis appralw^an�Anow Ne eame to 6o Ime ac,1 mrteU.AO 0��^5 0�Ixws enC cAmances govemmg Nis lype ol work w'V�e mmp4M <br /> wni�wnM�e�spea�MG�emmornol Theqrnntmpolaperm�Goesnalprewmerogrvcau�orrtylovn�ieoreinalt�opmn4onotanyoNers'�afcorbcillawreguLnmgmnsnvrJron <br /> i0at I am autl�o�¢N OY��e m+^er ol �s pmpeM�o Derimm pie work lor whiY�appl�rn0on r,maJe and I comply n+th Ihe Slale Canhatlors Law 18 P RCYJan0I9tt.100A IVnC <br /> �Zd�3 <br /> O er/A orizo Agent i atu Oate (Rrvis�d 620R) <br />