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� . <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKL�R/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., [verett, WA 98201 425-257-8810 FAX q25-257-8857 www.evereltwa or <br /> APPLICATiONS ARE ACCEPTED FROM 8 AM TO 4 PIN _I !/ ��� <br /> SITE ADDRESS: <br /> �'�7 / UR� ��r. FflOFEHTV TA%p P FMIT q <br /> LEGAI./or newconstmclion Snon PiaUsuOeivision <br /> Lol No__ (���a�p rqPY ol bng Iegdi acscnphon) <br /> OWNER ({j� /.:,' /�'� pponci6mail <br /> �S ^ ^�- .. 593� <br /> naa���s 3�'0/ o!j/:' /_ <br /> CAy/Stulell.ip ��'_,QF�/ /,� . B.�J <br /> APPLICANT:�p�vner �_Ownefs Agml _Contraclor W <br /> �Conlraelor'sAgenl _Tenan(im,sipm.noaeneroiwmemtomNoc..nc•ueo+anmi�uroacu) <br /> CONTRACTOR <br /> — L&I Lic # COE Bus Lia q <br /> �Oaress <br /> `— —' Pnone;Emad �-- <br /> TENAN7 BUSINESS NAME � <br /> CONTACT FOR PERMIT <br /> P�onc/E�m�il / <br /> BUILDING pERMiT APPLICATION <br /> CONTRACT PRICE OF WORK <br /> Evisling Usc of Ou�lding , �— <br /> Proposed Use of Bulfding � '� HEqT SOURCE� <br /> Builtlin t e Gas_ Elrcinc_� Olncr <br /> 9 YP � ._Single Family _Duplex Townhouse Multi�Famd — <br /> Y _Commercial <br /> Type ol projecf _New _qtlddion _Remodel Repair T.I. Si n S rmkler - <br /> CESCRIPTION OF ORK�add,nonai space Pro��ded on rne oacti): � --� P --Dertiolition_ _Change o(Use <br /> /"� <br /> ��,� Qua <br /> MECHANICAL pE RMIT App��CqT10N <br /> PLUMBING PERMIT APpLICATION <br /> 7ype ol Prqect: _New_ptldn Aticralion_Hepalr <br /> Shuw Num4cr(a)olliafures TYPe ol Pro�ecl: _New_AJ�n �q������{o�_Repair <br /> A/C—a�r hanUling unds 5 ow N�imber(u)of lirfures <br /> Porcetl au syslems Todcl <br /> Gas P�P�nq OaOrtub <br /> Walcn c�ater \ Wvatory(wash ba,in) <br /> Cas 6repWcc \Showcr <br /> Gas ranne tchr.n smk 8 tlrsposal <br /> _ Clothes dryer ���4�washer <br /> Ranqe hood Cloih��washcr <br /> t.Mhaust lan N1:rtcr he cr <br /> cal pump SinA(scrviceYqv/mop/c�C) <br /> Ui hcaler ���ckllow preven <br /> �odc Unnal <br /> Rchiqcralion ���inkinq Fountam <br /> Woodslove '� Floor tlrain <br /> Ouc�in9 Grcasc Irap <br /> Olher Rooldrams � <br /> SPRINKLER / SUPPRESSIO Y Memca�cas <br /> STEM ou,r.r. <br /> Number�I Heatls <br /> Other. <br /> I M1nrpY«••'V I�ial I h��m rea0.mtl e�nmmeJ Ilu:apl�i<oe�n xnd lnaw Iqe r.ame In Ln�mp anU mnecl All pionsmn•.OI Idwg nnd arum.�nces povMnmp Ipr M�e olwurk mll Ge-omplrJ <br /> w�tlw!IC�Il�ltp��<iliC4hClCillnfnpl.illf.�l:lfl�'.I�I�plll(ICITi111oC51101(IICSI�mplpqiVOl1u111M �nyiol.11i! <br /> TMtlmm�iMnnn. h or[nncrll��pransnnolanYnl�c�51a1emIMalLtw�epul�I�nBmn;IruUmn <br /> � ��Y��n o�wnrr o11Me prnpetly to perloim mn vioM inr wli;t�nppsca!io�ia mape one I eompt�w1�ihe Slnlo Conlnqoi.lnw Ip 3l RC W nnd�9�zODA VI4G <br /> � .—�f----- 9 .�,�,iz <br /> /Owncr/Aulh nmd A'qenl Siynatum <br /> �� � / Oa�c <br /> (RcnxA G/PO17J <br />