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� t <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, W,4 98201 425-257-8810 FAX 425-257-885? wv✓w.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I� 'D� '"�� <br /> SITEADORESS: PNOPERTYTA%Y PERMIT# �,^ <br /> is�� ( �,�ETmo�� AvE ��3� o3�7aoioi z uc� <br /> LEGAL lor new conr'�ucbon Short PlaVsubtlrvision Lot No_ (attach coPY o�long legal descripbon) <br /> OWNER � � �, Y Phone/E-ma�l <br /> ACtlr?ss Gry/State2p <br /> APPLICANT:_Owner O�anersAgent i.ontractor Contractor'sAgeni ienant�r�+io���oea��r.��o��.o-.•�-,inomi�o..�o�ma��. �nesoacei <br /> CONTRACTOR u 1�)N� �� i 1'�'1 �C � /� L 8 I Lic.#�A��Kii��t'1 i'I�� COE Bus Lic.# �� �`� <br /> ndaress �J`�`�?� I 5�� p"L"� l��-� J`,�F� `1���� Pnone�Emad C��G ��Sz—S�G'�' 1 <br /> TENANT BUSINESS NAME CONTACT FOR P°RMIT' G�F Sj,-�KS��� <br /> 21"E-3�z—S�4� I_( n . <br /> PhonelE�mad �G��`c,SC`L�/ic�i�`'IS�nI(=,C.fn'1 <br /> BUILDING PERMIT APPLICATION CONTRACr PRICE oF woRK <br /> r' " HEAT SOURCE�. <br /> Existing Use of Bwlding 7r� <br /> � <br /> Proposed Use of 8uilding �F�� Gas_ Eiectnc_ Otner_ <br /> Building type�. `�Single Family _Dupiea_Townhouse _Multi-Fam�ly _Commercial <br /> T pe of pro ecC New Addilion �Remodel Repair TJ. Si n Sprinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(adtlihonal space pm�-itletl on tne bactil. _,_._ ^, n <br /> ��LvN l`ri��J ��i`S�'�'1!G ��_T1�O��T 'Z� 'C��1�'��t��!�.�.'T CiF S�� f'�L �'ii.i <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type o�Project: _New_Addn _Alteration_Repair Typa ol Projecl: _New_Addn _A�leration_ftepalr <br /> Show Numba(a)ol firtures Show Numbw(C)o!Litures <br /> A/C—air hantllin unds I Toilet <br /> Forced air s stems I Bathtub <br /> '� Gas pipin I Lavato (wash basin) <br /> � Water heaier Shower <br /> Gas Greplace I Krtchen sink 8 dis osal <br /> Gas ren e I Dishwasher <br /> �� Clothes d er Clothes washer <br /> � Ran e hootl I Water heater <br /> � Exhaust fan I Sink(service/baNmopletc.) <br /> Heat pump BackOow preventer <br /> � Unit heater I Unnal <br /> � Botler Drinkin Fountain <br /> Refn eration I Floordrain <br /> Woodstove Grease�rap <br /> Ductin I Rool drains <br /> Other ! Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Otner <br /> � Number of Heads Otnec <br /> I n,y���.y�mlRy Il�at I l�ave reaG and eRamined l�is opp4Glwn an�f!nnw itm same lo Cr Ime an.1 bnecl All pmvsions ol laws and oN�nnnces goveimng�Ns type ot wotk vnll�e mmpl�ed <br /> ..v,[�,.Jr��fipect u0 harein or nul l�e 9ren�ing ot a Pa�it I .n..l p'.±�d..f J'. � �ettion y b ...,�o•ou�.�I I..i�ovisun ul��t1 N'or s�ale or bUl law Mgupi n�J conslNd�on <br /> I I�at i:ini au0oni44 t�y I�c ownci ol lhis Pmpofty lo PeNorm V _n c:v.P.� y ,.ci,on is ni d � �1 I :on.p,y .I Lie 9aL,Cu+t acb�s t a�a 16.]HC�4 ana 296 30.1A�1AG <br /> / / <br /> Y `, \ ;�`\c� _ <br /> OwnedAuilmnred A9mi1$ignature Dale iRev.sed620f2) <br />