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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar 5� , L=verett, '�VA 98201 425-257-8810 FAX 425-257-8857 ��n�r.v.evere�lwa or <br /> � � � ��� <br /> SITE ADDRESS: T H PROPENiV iA%fl PER67R <br /> 50 3 05 �-1 S` � � � <br /> LEGAL for n?vi conshaction� Shoit PlaUsu64ivision_._ Lat f;o laitash coFY of�ong I=_gal descriplion! <br /> OWNER =, � pUG TLQ-� PhonelE-rnail y2_ -3� - 9Zoc <br /> ?Cdr�.., CAy/S1aP_'710 <br /> APPLICANT:__Gvm_- Oune?si�genl X Contractcr Conlraelof.Ag^_nl _ ienae�pn,,::;o�v^.oa�..:o-�a�:-.•=-isr.�,�.r�c.�•�mr,c.. .,��ose.��.�1 <br /> CONTRACTOR�GN�,t/i.sQu1�'1=�- �?GES LCL Stale Lic. U TJVFRASLSI I G.,� Cdy Bus. Lic. �t <br /> Atldres; � 3.� �O'�(.� pC'V�.{ � Phore;"email S ' Y�O- TJ� <br /> TENANT BUSINESS NAR9E CON7ACT FOR PERMIT <br /> Fl��onel[-r.ad <br /> BUILDING PERMiT APPLICAYIOPJ CONTRACT PRICE OF WORK 1 r O� <br /> Ex�sling Use af Budding HEAT SOURC[�. <br /> Proposed U=�c/6uilding Gas _ Ftectnc _ Omer__ <br /> Bwlding type _Sirg'e f��m�.i�� __�uplex_Tc�mhouse _�:1uI�i�Famdy}�_Ccmmerc�al <br /> ��ypz ef piqe�l r,�:: acd�i�en RemeCH __R?pnir _T I __ Sign _SC';n�Jer_ _Gemc'iLon Chan,e ol U=_�: <br /> DESCRIPTIONOF WORK;ac�:hwr:�<p�cr.�.,o., :!^:inn �ep�c�1 �C���T`ZU� Oi� C�kS P'"1� IC-�- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoafPrcjecC _Neei_AJdn KAlteration_Repair TypoolProjecl: _Nr:i_Addn ^Alleration_Repair <br /> Show Numbcr(pJ ol7ixNres Show Number(tlJ a/li.(ures <br /> NC-air handling units I Toilet <br /> I Forced air systems I Uathto6 <br /> � Gas piping Lavalory(�vash basin) <br /> Water hzater I Show.:r <br /> Gas fireplace � Kilchen s�nk 8 Jisposal <br /> � Gas rarge Uishv;ashcr <br /> � Clothes dryer I Ciothes washer <br /> � Rangehoad Waterhea�er <br /> � Fxhaust fan I Sink(servicelbarlmopletc) <br /> hleal pump I �ackCcw preveNer <br /> � Und heater I Urinal <br /> � E3ciler �rinking Pountain <br /> � Refrigeration � Floor drain <br /> Woodstove I Greasa trap � <br /> � Dur,ung � Roo(drains <br /> � Other Riedical Gas <br /> SPRINKLER I SUPPRESSIOW SYSTEM � oiher <br /> Num6erofHeads � Other. <br /> I�erebyce�lylhallhme�eaCande.am�nedlh�sapP��T��-��ndknaxthC;aTo�otelrveandcorrecl Allpmvisioaso:lawsandortliren<esgovem�r.glh:slypeofnmMx,➢hewmp'�.ed <br /> �,sii�whetnCr speu`ee�crein or ncl.Tna graN��g cl a pertn:l dces ncl presu.ao lo give autpor:ty ta vloia!e er cancel me pmvisicn cf any cTer s�ale oi lowl law regWating ccns�m.i'cn <br /> T9al I am aulhcrizeC Ey Ine owner ol:�is pry. y la pertorm!�o wcrk fet w�::h xpFCcat'�on�is made an01 ccmp:y wilh ihe S!a'e CoNracbn Law Id 77 RCW en0 29E 2COA l4'AC. <br /> / �, lo;�-/ <br /> .���de�er .�.��i e���.i��„�_���.� n,i� ia„o��ad a,7mai �' .. --- ... <br />