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� � <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLE�/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, WA 98201 425-257-8810 FAX 425-257•8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED F�•�M 8 AM TO 4 PM SSU q- UZ <br /> SITE ADDFjE S: FROPERTV TA%Y P�RMIT <br /> 60 O -� <br /> LEGAL lor new Consiruchon Shon PlaUsubdrv�sion 4�3 QG ot No (attath fApp of long Icpal desCnption) <br /> OWNER s Gl,ji'�, , L-LG P!�one/E-mad L/ � �j�'j, - �C �/' l� <br /> ndaress p D c�ryutareizn U nG �}� o(� <br /> APPLICANT: Owf�pr OwnPrSA(Jpnt COn�fdCtOr COntr2dOf5Aqpn1 TEndnllmmioA+�aeaimerehomemrtcamewnerireo+enmbesoa:o) <br /> CONTRACTOR L{/Nt k''S < G'H L 8 1 Lic # E Bus Uc d <br /> A47ress PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> � te /�in�� <br /> Phone/E�mail - � � �(p <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Ezistmg Use ol8wldmg_ /'� HFJ\7 SOURCE� <br /> Propased Use of Bu�ld�ng e J 7'� Gas � Eiecv�c Omer <br /> Bwidmg type�. �Smgle Family _Duplex_Townhouse _Multi�Famdy _Commerual <br /> T pe ol pro�ect New Aadrtion Remodei Repair_T I Siqn__Spnnk!er___Demolition Change ol Use <br /> DESCRI PTION OF WORK(add hona�sn�3ce pro� ed on rhe back) /� <br /> COhS� rUG� �/ �L{�HDO�� S' ',�� 1 ��C/JO �ll�"'�ld� <br /> „� � � <br /> QCaAI` oh nlf�chc�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: New_Addn _Alteration_Repair Type al Praject�New_Adtln _Altera�i m_Rrpair <br /> Shaw Num6er(M)ol lirlures Show Numhrr(M)o/firiures <br /> NC-av nandl�nq urots Totlel <br /> Fo¢ed a�r s stems �athtub <br /> Gas piping I avalory(wash basin) <br /> Water healer Shower <br /> Gas 6replace Kilchen smk 8 d�sposal <br /> Gas ran e Dishwashcr <br /> C�alhes d er Clolhes washer <br /> Rangc hood Water heater <br /> F�haust fan Smk(5ervice/bar/mopleiC � <br /> Neat pump l3ackllow prrventer <br /> Unil hcater Unnal <br /> Uoder Dnnkmg Fauntam <br /> ' Retri eiaUon Floor drain <br /> Wootlsrove Grcasc irap <br /> DucUn Rool diains <br /> Ol�r_r Med¢al Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM Other <br /> Numbcr of Flcatls Other <br /> Illerepycef�dylhdll�dvPmdOan�p�aminS0Uu5dpp�'W�Nndn�InnwtlieSamelo�elmC,l9aconrr.l Mlpiovisionso11dw5tn0ord�ndncCSqovC�Nnr�l�6lypeolw^IIwtll�RtnmplM <br /> wd�w1ic10cr eprtd��etl�erem or nnl !hc granling ol a prmul OneS nul pmsumc to 9rve aul�onty lo vwldle or Gnccl�he pmvumn ol anY othrt slalrt oi boil Nw irqulaLnq contdnid�on <br /> tl�ai I am auR�oved�Y Ilic owncr ol iles prnpmty In pedom�Rv,wo�A lor w�iUi npl�+Ulon n maEc ami I coinpN+�����r.Si.Tn f,onlr.�rlor..I.,�w 18 d]ftGW and�9G 100A WAf. <br /> - � /L // , �'� <br /> � <br /> Own dA IhorireAAqe �9nalurc ' D. C (ReviSeAfi;'072) <br />