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� <br /> :r <br /> ._'� <br /> PERMIT APFLICATIO�V <br /> BUILDINGIMECHAlVICALIPLUMBING/SIGNISPRINKLERIDEMOLITION ,:: <br /> �� <br /> CIT`( OF EVERETT PERMIT SERVICES � � <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.2verettwa.org I � <br /> ApPLICATi0N5 ARE ACCEPTED FROM 8 AM TO 4 PM �d 7� �Z <br /> SITEADDRESS: �2��U 3QlC arsorearv7nXit �-' <br /> !2 3 .sT o05��oozz.o�oo � P i'��-o3 <br /> LEGAL for nevi conslmction: Shod PlaVsu6division Lot No._ (attach copy of long legal descriplion) <br /> OWNEP. � ( ('./l.,)G{V Phone/E-mail — S a —�%� <br /> Address ��25 VL CitylStatelZip ��G E��j 1 � <br /> APPLICAhT:�,Owner Ov+ner'sAgenl Coniractor _ConUactor'sAgeN __�ewnllmm:c�maaonicn�rcrto�senur�mm,oNnerioaowo:wmmaspawl <br /> CONTRACTOR CJ l-�~'"��'r L&I Lic.# GOE Bus. Lic. � <br /> Ph�ne/Email <br /> Address <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> PhonelE�mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OP WORK C�C� <br /> ExistingUsea(�uilding w�RLt"�OV« HEATSOURCE: <br /> Proposed Use of Building �� Gas__ Eiectric_ Other___ <br /> Building lype: Single Family _Dupyle�x_Townhouse _Mulli-Family �Commercial <br /> Type of project_New _Addition 1 Remodel ._Repair_T.I._Sign_Sprinkler_�emolilion_Change of Use <br /> DESCRIPTIONOFWORK(additionalspaceprovidedonfheback): [L��DI/� �J«5?//U(i7 ��Rr�OwT� <br /> SavS'f+k�L. R H/Cw Ct�rrtiM[r�Ci�L. ^/UtAN- TJoo2,�� AniZ� .�,�1Fi'�! �Zt�In��v��C <br /> wt�uDow w�r� C M U 's <br /> SPa cG <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERN9S'�' APPLICATION <br /> Typo of Project: _New_Addn _Alteratlon_Repalr Typo of ProJecF. _New_Addn _Alteratlon_Repair <br /> Shmv Num6e�(#)o(/ixtures Show Number(NJ o(/ixfures <br /> � A'C—air har,dling unils 'i Toilet <br /> � Forced air sys�ems I Balhlub <br /> � Gas piping I Lavatory (wash basin) <br /> ! Water heater i Sho�ver <br /> � Gas fireplace � Ki!chen sink&disposal <br /> Gas range I Dishwasher <br /> � Clothes dryer I Clolhes�vasher <br /> Range hood � Water healer <br /> Exhaust fan � Sink(service/6ar/mop/etc.) <br /> Heat pump � Backflow prevenler <br /> � Unit healer I Urinai <br /> Eoiler I Drinking Fountain <br /> � Refrigeralion � Floordrain <br /> Woodslove I Grease�rep <br /> Oucling I Roof drains <br /> Cther � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> I Number of Heads � Other: <br /> I here0y cetlAy Ihal I w read and examined�his applicafon and knoa the same lo be Irue and wrmct.All pmvisions ul laws an0 ordinances govemin9lhis lype ol work will be complied <br /> with wh her ecilied he in or nol.Tho granting ol a permd daes nol presuma to glve aulhority to violale or cancel tho pravisicn ol any cther sta!o or local law reguletln9 construdion ' <br /> That I uthorized hy th o�rner ot this pmpedy to perform tho�w�k Ier vrhic�appllcation Is maCe and I eomply wM tho Slato Contraclors La�,v�827 RCW antl 29620�A N'AC. I � <br /> �f� <br /> ���� 9-2��-i2 " <br /> �._ _..�,�. , <br /> _ . . . . _. � �� -- _ -� ,_ �as� <br />