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P�RMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.or <br /> l �l�l�/� <br /> SITEADDRESS: �j}�jjyp3 PROPERIYTAXtt PERMiTIt <br /> 6C e�/'//� ` �.�e �w -O � <br /> LEGAL for new construcliorc ShoA PlaVsu00ivision Lot No_ (attach copy of lang Icgal descnplion) <br /> OWNER �A�t�t �aT .�C. �-L-C- Phone/E-mail � <br /> Aaare55 F� B�k �as/ Ci�y/Slate/Zip S�to/e�rie GJif 9�1� c> <br /> APPUCANT: Owner �OwnefsAgenl Coniractor _ConlractofsAgent TB��ni(mmi0:c.�eoaianerai<ansentrtwn��eo,.nerioConoa�nmaspace� <br /> CONTRACTOR T�..� Slate Lic.# TU� �O'7 O D Cily Bus. Lic. # <br /> Address �?$��� xI �� J�(y}�D ¢� �p� Phonc/Email �fZ3 yr� S3/(J <br /> TENANT 6USINESS NAME CONTACT FOR PERMIT <br /> —� S7ti{!4 Cwi�n <br /> i{�L'� PhoneiE-nail ?.6� $(7 O 6�'�� <br /> BUILDING PERMIT APPLICATIQN CONiRACT PRICE OF WORK !S, oo� <br /> Existing Use of Building�,OI� C�¢,itclL8il.ii— HEAT SOURCE� <br /> Proposed Use of Bwlding �Yw-- Gas�C Electric Ofher <br /> Building type�. _Singie Family _�uplex_Townhouse _Mulli-Family _Commercial <br /> T pe of pro�ecf. New _Addition Remodel _Re air_TJ._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION,OF WORK(add�nona!space prvvided on me back): <br /> �t/ Fi[L �e,��i,�iN� G.�GL/�9o2 � aF,r Odl�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJoct: _New_Addn _AI(oratlon_Ropair Typo of Pro�ect: _Now_Addn _Altoration_Ropair <br /> Show Namber(ll)o/fixfums Shaw Nunr6cr(a)ol listums <br /> A/C—airhandlingunits � Toilet <br /> Forced air systems Bathtub <br /> Gas piping � Lavatory(wash basin) <br /> Water heater � Shoµer <br /> Gas f�eplace Kitch=n sink &disposal <br /> Gas range Dishwasher <br /> Clalhes dryer I Clothes washer <br /> R.•nge haod � Water heatei <br /> E�haust fan Sink(servicelbadmop/elc� <br /> Heal pump I BackOow preventer <br /> Und heater j Urinal <br /> ! Boiler Drinking Fountain <br /> I Refrigeralion � Floordrain <br /> Woodstove I Grease Irap <br /> Ducting Roof drains <br /> Other � Metliwl Gas <br /> SPRIWKLER / SUPPRESSION SYSTEM � Other <br /> Number of Heads � Other. <br /> I heieby cenuy Ihat I w r aa and eaamined I�is app6canon anC knowtl:e sama lo be hue ond cartM.All provisions ol laws end erdmonces goveming Ihis typo ol wo�k will be complied <br /> wnh w�et�er s e re �er �n or om TAe qraming ol a peimn tloes nol D�esume to grvo authomy�a rioiala or canttl t�c provision ot any<iher stala ar local law regulating construn��on <br /> Thal I am o' y I e owner of i�ie proDeny to perlortn I�c wark lor wniN app�iwtlon Is maEe antl 1 mmpty wnh t�e S�aic Conuacten law 1817 RCW anC 29fi 100A WAC. <br /> �✓ T�-� <br /> /i�iv i� /�, <br /> Ownor ut orizodA ontSignatura Daic (Revised.720f3) <br />