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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLfJMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, �VA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �I �I�7 `�Z/ <br /> 51T ADDRESS: PROPFRTYTAXp PERMIT% <br /> ; b��v�. OlJ 60� o yo � -� <br /> LEGAL for new conslmc;:on: ShoA PlaVsubdivis�.cn _Lo�No._ (atWch copy of long legal descrip�ion) <br /> OWNER f � PhonelE-mail <br /> Address City/S�ate2ip <br /> APPLICANT:_Owner Owner'sAgeni �Coniracior Conlracior'sAgent _Tenanllm�sio�:�:�x�i°:'°���c;-,s�-ii�ommec.�e�ioeo+.-c,���mespa:ei <br /> CONTRACTOR � a � �7 ' t ��-S L&I Lic.# �� 1- �O� COE Bus.Lic.# Z' <br /> t.ddress � - � ,5✓/ �L �%l /D � � PhonNEmail y�s'-3`'(���(lZ7 / <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-ma:l , '-"^�" `�^S _���_�U�� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> HEAT SOURCE' <br /> Existing Use a(�uildiny <br /> Proposed Use of 6wlding Gas_ Eieclric__ oiher_ <br /> Building type: _Single Family �DupYlex_Townhouse _Multi-Family _Commercial <br /> Type of pro ect: New _Addilion L Remodel Re air_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESC RIPTION OF WORK(addrtional spaca p�ovided on the back): <br /> Chan�� O� `l�� -�E�n=u�i�^ , <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type o�Projecl: _New_Addn _Allaratfon_Repalr Typo of ProJecl: Sh weNurt�ber(N)olli f o crstlon_Rapair <br /> Show Nunrbcr(Nl o(/ixtures <br /> I NC-a�r handling units � Toilel <br /> l�athtub <br /> � Forced au systems . Lavatory(wash basin) <br /> Gas piping <br /> Water heater Sho��:er <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range I Dlshwasher <br /> � Clolhes d er ; Clothes washer <br /> � Range hood I Water he.:�er <br /> I I _ Sink(serv:ce/badmop/etc.) <br /> Exhauslfan <br /> � Heat pump I Backflow preventer <br /> I Und healer I Urinal <br /> ! Boiler I Orinking Fountain <br /> Refrigeratia_ I Floor drain <br /> � Woodstove ', Grease irap <br /> � Duct;ng I Roof drains , <br /> ' Olher____.— I MedicalGas <br /> SPRINKLER 1 SUPPRESSION SYSTEM Other. <br /> I Number af Heads Other: <br /> l_ <br /> i . .d.ycerl!yV�allhavereatlantlem�n�ne�ttsa{ 'cn'�=�antlkc:.vlhes�meWbotrueendwnecLA�Pmvlsionscllawfe�tlord�nanresgov m�nglR�slyc=c�wokw�,Cbecemp.�e] <br /> . -.I��.�'�.or speulioG�mein or nol.ihe y*a�ih a�� �C '�n t i':c ,' Fe=�.ime m one a���.�ority lo doialo or wncel IDo provtslon el ory ot�er slale or tocei la�v regula ,�3�nsimctan <br /> . i.r,i-� 'liotlzetl hoow�:ri�.efc ,,.nlP.e �.!cn•.'-_�iap�'� �L�nisnnae�ntllce^iCYx.'�tie5:ateCer'ietc�SLa.v1827PG1Vantl2B5�C �1N�4C <br /> � �. <br /> ii <br /> Owncr/Aulhorimd A9mri Sipnalurc <br /> Lnle �Rensetl 6/2072) <br />