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���nni� ��P�Ac�T� <br /> BUIL.DIN(31MECFIANICALIPLUMBINGlSIGNISPRINKLERID�M�LITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evere�a.o�` 15 <br /> SITE DDRESS: <br /> PROPER7YTN(11 ER I*# ! QI <br /> /� f,r� tnD�P� � <br /> LEGAL for new conslivclion: ShoA Plallsubdivislon Lol No._ (altac�copy of long legal descAplion) <br /> OWNER �I,Q JQ ee a��c��D�ir�1�' �IPmA��- ee PhonME-mell Zdb-¢ -�'633 p <br /> naeres5 $/5� �,1pfi���e �- c�ryisia��rz�P p✓� ��- �d y�� <br /> APPLICANT: ✓Owner _OwnefsAgent _Coniractor _CoMraclor'sAgenl _TenaM�m�+�r�m+eooien�rmwmomnommemm�rioaowonhin�spa«) <br /> CONTRACTOR <br /> Stale Lic.# Ciry Bus. Lic.# <br /> ' . Phonc/Emaii <br /> AEdress <br /> c <br /> CONTACT FOR PERMIT <br /> PhonNE-mail � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> ��,�e {�m;�,� �,�,;��,,,�e HEAT SOURCE: <br /> F�cisting Use of Ouilding � ' — <br /> �Q ���.,,�v� rL.Q)�.(p,..,c,e., Gas_ ElccWc_ Olhcr� <br /> Proposed Use oi Building S��"'P �— � <br /> 6uilding type: ✓Single Family _Uuplex_.Townhouse _Multi-Family _Commercial <br /> Type o1 project: New _Addition _Remodel _Repair_T.I._._Sign_Spnnklcr__Dcmolilion^Change of Use <br /> DESCRIPTION OF WORK;addifionol space provlded on fhe back): <br /> �'e— ✓��',�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProject: _New_Addn _Alteralion_Repalr TypoalProject: _New_Addn _Alteration__Repafr <br /> Show Numbcr�N1 o/lixfurcs Show Numher(p)o(fixtures <br /> AIC–air handling units Toilet <br /> f=orced air sys�ems �alhtub <br /> Gas iping Lavatory(wash basin) <br /> Water he�ter Shower <br /> Gas Greplar.e Kitchen sink R disposal <br /> Uishwasher <br /> Gas range - ' Clothes w�sher <br /> Clolhes diyer Walcn c�atcr <br /> Ran9e hood <br /> Hxhausl lan Sink(scrviceNadmoplr.IcJ <br /> [lackflow preven�cr(inside bldg) _ <br /> I leat pump -- Urinal <br /> Unil hcater — Drinkin9 I'uuntain <br /> �oiler — Floor drain <br /> Refrigcration 1 Giease Irap <br /> Woodstovc — � Raof diains <br /> Uuclm� --- Medical Gas <br /> I Other_ <br /> SPRINKLER / SUPPRESSIOM SYSTEM _ othcr: <br /> Number of Ilcads <br /> other: <br /> I hcmby�mhlyl�a�I Mva rcod nnd c�nminrJlhi,ippllcalion nnd An�rx��c same la be truc and correG.MI piovisinns o1l.rxa nntl oidinances 9ovcmin9lhi,lype ot worY w'�be com�dicd <br /> wnhwhelher• etifmdhemimm�ol.T�eqranlin7olape�mdtlne:nolpm;umclo9neaulhonrytoviol�lemcancel�heprovisionolnnyolherslaleor!owllxxrcgulalin9�anstmcllon <br /> Ihallam�ul aiimdbylhco�meial{M1i,pmpe�rytopcdortn�0ewoikloiwAichappPwtionismadcanAleoiryilywi�hlAuS�aluConlracmisL�w1R7713CWand."90.1�OAWn(:. <br /> � {/(,�� .//� }� <br /> � �.. p�� �%�'�l� ���.�—+� " '���—/� (Revised 4!.?Of:i) <br /> `OwacrlAWhoti�c Agcn�SignalurY e��—�--- Uatc <br />