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� � <br /> PERMIT APPLICATION <br /> • BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32C0 Cedar SL, Everett, WA 98201 425-257-8810 FAX 425 257-8857 �v�^nv.everetiwa.org <br /> 1 -v - �S <br /> SITE ADORESS: PROPCRTV TA%q P •1 T <br /> O r oa �ao D - <br /> LEGAL(or new cons!ruqion� Shat PiaVsuCtliwsion Lot ho (allach copy ol long legal tlescdD�lon) <br /> OWNER ��C�-{f,�(� �jr Phane/[�mail ZS`Z,3Z` �73 <br /> AdCress � — �� CdylStale/Z�D G�Q O <br /> APPLICANT: O�n�ner ' C�ener'sAgenl �Coniraeior CoNmcior'sC9ert _Tenanl(T�sip�a�aeair�:e.acccs�r,oc�moe,emm�.cnnn.:;a:e� <br /> CONTRACTOR � �N L.J1113 State Lic � � �{y�Ci�y Bus lic. il��I� <br /> ! L i✓�✓ GU�-q�U3 25-77 ' <br /> Adares; Phune/Emad � <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT g�/�) ��i� <br /> Pncnc/E�ma�l y2 "J����IOY(/'/� <br /> BUILDING PERMIT APPLICATiON CONTRACT PRICE OF WORK���,l/t') <br /> Ezisl�ng Use of f3wld�ng HEAT SOURC[- <br /> PropoSed US?o(Builtling Gas� Eleclric_ Olher_ <br /> BwlAing type �Singie Famdy _Dupler_Townhouse _f/'ulti�famdy _Commercial <br /> Type ol Uro�ecl Nev+ Adddion Remodel Repa�r_ T I Sign_Sprinkler_�emont�on_Cnarge of Use <br /> DESCRIPTIONOFWORK�acy.�,o�..�s,�.e�ie��ieevc�meo�c:1 REpLqCE Ej(�ST7� EG.EL772�G ���T– w <br /> T,4,�lK WrM � �� GAs No i Wnr� T�4-N K �'� -rNe �An+� Loca-n�,�l� <br /> Na nlecv Grts P,c,u�-. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolPrajeci: __Newv_Addn _Alteration_Repair TypeolProjecL _New_Addn �Alteralion_Repii� <br /> Show Num6rr(n)oI Lrfurrs Show Number�N)ol h.fures <br /> NC–air handhn9 umis I Tocel <br /> � forceJ a�r systems � F3athtub <br /> � Gas piping � ... Wvalory(wa5h 6a5in) <br /> � lNater heater � SLov.er <br /> � Gas(irepiace � Kitchen smF.&disposai <br /> � Gasran9e � fhshwashcr <br /> � Clolhe.s dryer � Clothes�vasher <br /> � Range ho�d � W:der heater <br /> —� Exhaust fan � Sin0.(servicc/barlmop.�cle) <br /> Hcat pump I Uackflo•.v nreveNer <br /> � Unil healer I Unnal <br /> � �oJer � Drinking FouNa�n <br /> � Refrigcrapon I Floor drain <br /> � Woodslovc Grcase Ir�p <br /> � Ducting � Raol drains <br /> Other � Medical Gas <br /> SPRINKLER ! SUPPRESSION SYSYEM � Olhr.r <br /> Numbero(Heads � Olher. <br /> i rrrcEY�emfy ih?I I Aa:e read anC e.am�netl��is appLca��.on xnd Ana.v I�e same m�e Iroe and co�mo Pli piov�s.ons o�la�.vs�nC o�d:nances 9overmng mis rype ol�w�h nll ee cump�._�tl <br /> �cnp wnetner speu�ie0 I'erem c�not ine gianting of a pernA aoes ne7;iesume�o give aN�ciuy la rio�J'e or ca.icel Ine p'o+isian ot xny elner slala ar lowl law�egul�ling mnsim:l:on <br /> Tnai I am aulno�i:ed Cy t�e owner ol tNs pmpe�y to petlo�n��e e.o�S lo�w�lc�aCPl�.cal�on is maae antl i compy xn�i�e Stale Conlractors law IB 7�RC\V and 396 200A N'AC <br /> L�zte�SU 1/�//.� <br /> OwnedAut rizetlAgentSigna�u �� (Fe�is�tl?R013J <br />