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• �ERMIT APPLICATIO� <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., [verett, WA 98201 425-257-88t0 FAX 425-257-8857 wewv.everettwa.org <br /> SITE ADDRESS: + � � �• � PROPEaTY TA%a pv��nR�T N �� <br /> I 1• I <br /> LEGAL Ior newconslructio� Sr�oit Plausubarvisian Lol No_ (andcn copy ol lony legat tlescnp;ion) <br /> OWNER �(' (' C�a.7Q�` pnone�6ma�.l �� —3 y� <br /> AOOress 13v (, City51alc2iD L VY(� I W fT ���V <br /> APPLICANT: _Ow�C. _Ovmet'SAgCnI �Coniratlor _ConlydCior'SAgenl _Terami��„s:o�maea�ver���.�m�,.rri+cmrec.��+�,�av�n ��mosra<oi <br /> CONTRACTOR '�Z E Stale Lic # Z (TI �' I y��/ City Hus. Lic.# O� O 6 <br /> aaa,ess 0�3�� �� Ave � Cal /7 no,e.�em��i 3�.c�� . S O <br /> TENANT BUSINESS NAME CONTACT FOR PERrypIT <br /> P,o�Xy�e � �°2y �3G u•�f3S�� 5`�oY <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK lo l <br /> EK�sling Use ol Building FEAi SOURCE <br /> P�oposed Use of 0utltlmg Gas E'eUn[ Olncr <br /> Budtling lypc Single Family _Duplez_T.�mhouse _�dulti-Famdy _Commeraal <br /> t pe of io ect New Adddmn Remodcl Re air T L Sian S rinkler Demolition Char e ol Use <br /> DESCRIPTION OF WORK idOtl�hon�lsod[CD���4edontheDdch), <br /> �VI S��l �I 1"1"1\ � ` �n�i � �i1 i n Ej 4 n� nP,c.J �i.�nttv� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type o/Pro�ocC _Now�AAan _AtloraUon_Repalr Typa ot ProJoc�: _Now_AaUn _Altarallon_Ropalr <br /> ShowNunrOa a ollirtwes ShowNumOa p o//i+fures <br /> A�C -air handhn unils Totlet <br /> FarceA au s s�ems Balhluh <br /> Gas i in I Lavator (wash basin) <br /> lNalCt healci Shr,wcr <br /> C7as lirr. lacc Kdchen sink R Ais osal <br /> Gas ran e Dishwashc� <br /> Clolhes d� cr Clathes washer <br /> R:v�c��hood Waicr I�calcr <br /> Fxl��ausl lan Sinh servicelbarlmo lelc <br /> Heal um Hackilow prevenler pnsitle bldgl <br /> Unit healer Unnal <br /> Uoiicr Drinkin f�ountain <br /> Rclri eration Floor drain <br /> bVoodstove Grease Ira <br /> Dutlin Root drains <br /> Olhet hSnAiCdl G�5 <br /> SPRINKLER ! SUPPRESSION SYSTEM ptner <br /> Num6ei ol HeaAs Other <br /> I PC�eby ce�tity Ihdl I have�eaJ an0 nammC�11�R dOplKdLon,nU b�ow I�C samC t0�e ime an0 conttt ��II V�o�isinn5 0l Idws Jnd aidma�(M 9evemmg Ilus qpP ol w01t wll pe cOmp <br /> wrt�Nryulhcr speoLe�I�e�em or nol The qiani�n9 0l a pe�mt does nnl p'esume l0 9rve abitlonry lo nollle o�Wn<cl lhe pronsion ot any nihet sldle o�bWl Uw reguldLnq Ccnslmtlion <br /> 1Ta1 I am aul�onte�Dy I�c o�.ner 11�6 propC�T lo peNom I�e wnM lor�n¢�/Jpphcabon rs ma�c an;f I campN vrtl�Vie Slale CtMr,�ctors 1 aw IB 27�CW anJ 1oG200A WAC. <br /> �'V�// ' � <br /> 'OwnerlAulhor zed Agent Slgnature D„Ic �Revisetl�/.'O15) <br />