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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereri, WA �"o��; 425-257-8810 FAX 425•257-8857 www.everettwa.org <br /> �� 6-iS <br /> SITEADDRESS'. 7ROPERiVTA%tl PE MITM <br /> �� . #/0: � D 3' <br /> LEGAL�or new wmdmction S�on PiaVsaOCrvlsion_ '.ot No_ (attac�copy o�long iegai aesu�pUon� <br /> OWNER PhonelE�maii <br /> Aaaress C�ryl51at=2ip <br /> APPLICANT:_OwnCr _Own2�5Agenl COMraclCt _Con�raclor5A9en1 _TEna�i�mwio�m�aooenero�m�untnomo-vow�e.maawoni�monar�i <br /> CONTRACTOR Q . � State Lic.fi �� City Bus L�ic1.a�S`�+.t�7q' <br /> naaress S0D ��p�� l.L7 PnoneiEma�i ' S�"/ US C.[N Cmir S•L�� <br /> TENANT BUSINESS NAME CONTACT FOR PERMI� <br /> / , ^ ClLi Sd/17�(... <br /> �Q.S(��� !/LS/? PhonerE�mai S C1LT /YI/�ClL/�5.� /�l <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WnRK - O� <br /> Existmg Use ol8wlding . �d'�-='�- � HEAT SOURCE. <br /> ProposeC Use ol0uiltling Gas E�ectric Other <br /> Budding type _Single Family _Duplez_Townhouse _Multi-Family _Commeraal <br /> T eof roect�. New Addition Remodel Re art TJ. Si n S nnkler DemoG6on Chan e ofUse <br /> DESCRIPTION OF WORK(aad�no�ai space p�owdea o�tne oace) i <br /> s�-PP�y � lw���,�� , � s-��t�5 (�wr��-� �5����� �G ��f <br /> � � W X `'� Q: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Ad0•i _,Alteration_Repalr Type of Pro�ect: _New_Adtln _Alteration_Repalr <br /> Slrow NumDer Y of lirtures S�ow NumDcr a)o!/iutures <br /> A/C—air handlm unds Toilet <br /> Forced av s slems 6atntub <br /> Gas i in Lavato wash basin <br /> Water healer Shower <br /> Gas Gre lace Kticnen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clolhes dr er Clothes washer <br /> Ran e hood Water heater <br /> Exhausl fan Sink service7bar/mo /etc. <br /> Heat um Oackflow reventer <br /> Umt heater Gnnal <br /> Boder Urink�n Fountain <br /> Re(ri eration Hoor diam <br /> Woodslove Gicase Ire <br /> Ductin -' Ro_!drams <br /> Other Mediwi Gas <br /> SPRINKLER I SUPPRESSION SYSTEM OIh>r <br /> Number of Heads Ol�ier _J <br /> I�ereEy certM Na�I�ave read end e+dmine0 t��s appLralqn anE Fnow I�e same lo Ce W e anE cortecl AI O�visiom ol laws an0 oramanus Bovemin0 I�is rypo ol waA�WJ be wmp'� <br /> wM wimNer speoRea�emin or not Tne ganpnp ol a pemW Joes nol piesume to B�ve nul�onry lo vialale or cancel Ine pmvision ol any olner slale or loeil hw regulalinB conslmcuon <br /> Tnat I a�uNouaed Ey Ri owncry Nis O�GeRy lo petlartn t�e woik lor wmm�applsaiion rs maCe anG I wmpty wiln��e 9ate CanVaqors Lew 1B 27 RCW anU 2962�OA WAC. <br /> � 3�i� Z <br /> OwnerlA orized ent gnature Dale (Revised 9@074) <br /> �l� <br />