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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 42�257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO�PM <br /> SITEADDRESS��IIS S ekj1AJi+ Pp�PERiVTAlf11 PERMIT/ <br /> tnv� CC5G 3900 2C0 O <br /> LEGAL for rrew conswuiorc Snon PlaVsuDdrvision Lot No._ (atlatli copy ol long kgal Oescriplion) <br /> OWNER �10`>C�'� 4 SL`f�r�i ��r�G P�one/Email �G(�'�-Ol �o�Je�l.-•(eCSC,�j. ..-n��.�O.r <br /> neore5:5fl8 k,�i'�w � GIy15tatel7ip E..weY� �,ll� �IS)03 <br /> APPLICANT: Owner OwnefsAgenl ConVador ConVaclo�sAgent Tenanl�mmama.��eoeam�se.nr�m�ee�vmm.mnuewxwl <br /> CONTRACTOR Nu�tilt„+<<�+ x �.i�"w �� L81Lic.# �UJ�� f�EL U I�J���v COEBus.Lic./{ <br /> Atldress ����q Cl+�t�n �� �Y S��wM�i�� W'1 5dJ-�� Phone/Email �1-S-3y s" �6�j <br /> TE N BU INESS NAME CONTACT FOR PERMIT ��„�� ty�/ G�,�,��`�_ <br /> Phone/E-mai `I�5-���'IS'�I(�5 nwc>�criu✓3� ��o��.c�, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK a-� <br /> EzisGrg Use of Building ^�'�- Z HEAT SOURCE. <br /> Proposed Use ol Building �J�'G� � ��� Gas Eleanc omer_ <br /> Building type: �Single Famlly _Duplez_Townhouse _Multi-Family _Commercial <br /> T of ro ecl. New Addition � Remodel Re ir T.I. Si n S rinkler Demoli6on Chan e ot Use <br /> DESCRIPTIONOFWORK(aodmonaispaEp�ovideeonmebace): � . <br /> ��re ��r�-Ir�-e iC�9�.ce�rw��+ o� 3`03 s.{. Ic«e.-4 � 3J 3.� "1°P'^' decE e,+y�rs ,z�+nritl In res���..�1, <br /> 'f"i1L `X+rv+! . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa M ProjacL• _Naw_AdUn _lUbntlon_Repalr Type of ProJecL _Naw_Md� _Allantion_Rapair <br /> Sfrow NumDer ryq o/Rxtures Shorr NumDer(�)o/firhrrna <br /> A/C-a�r handhn units Totlet <br /> Forced air s stems BatMub <br /> Gas i in Lavalor wash basin <br /> Water healer Shower <br /> Gas fire lace IGtchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothesd er CloMeswasher <br /> Ran e hood Waler heater <br /> Exhaust lan Smk servicePoarlmo /elcJ <br /> Heat um Backliow revenler <br /> Unil heater Unnal <br /> Boiler Dnnkm Fountain <br /> Refri eration Floor draln <br /> Woodstove Grease trap <br /> Dudin Roof drains <br /> Other Medlral Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of HeaAs Other <br /> I�emq ceitly t�31 I t�eve rcae anE exertnneA Inb app4ralion aM krrow Ne Same Io Ce Inx aIM corted.M�ravlwne d iaw�f aM adinam.ea 9oveming Ns rype ol work'uill Ee mmpleA <br /> .Mh wfirlher speafcd herein or not.TTc grerNnq ol a pertn�tices not qesume lo grve aNhoMy to vdefe ar rancellAe prov�snn ol eny olher stete or bfal Liw�egulating mnsl�vtibn <br /> TAst I em auNavEC b�er ol thn qopehy to pMortn Ne+roik lo�whiU app4ration b made en01 mmply wM Ihe Slate Conl2non Lew 18 27 RCW an0 796 700A WAC. <br /> ��j � \I <br /> �-a6-�3 Z <br /> OwnarlAut�orized Agen151pnature Date (Revised 6?012) <br />