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� • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPI.UIVIBING/SIGN/SPRINKLER/DEIIAOLITION <br /> CITY OF E.VERETT PERNfIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-2E7-8857 www.everettwa.org . <br /> �� <br /> SITE ADDRFC. • PROPFRTV TA7(p P MI7'# <br /> Zt U . � b�;�.. �s�.T � 1`�o�0 Z <br /> LEGAL lor new consiruction: ShoA PlaUsubdivis�on�7cA�� `4�-� Lot No.3 3 (atlach co�y of lang legal Eescripl:on) <br /> OWNER� T�'l..4. `f��" IG �S P�cnelE-mail �(Z�i 953j ' 2�'+�0 <br /> Atldress (Z.0 $W• �C(/�{[r µ�Cc�� Cily/StalelZip �1J2.�C„t'( L(�•� q Q1� `' <br />� APPLICANT: Owner OwnersAgent _Controctor _Conlraclor'sAgenl _Tenant(m�spm.rooaionero�w�ser.=rmm;+.00wnenoaowon�mmaspa�) <br /> CONTRACTORS�AT�G C�A�'-�`«- E-S state�ic.#�'S�A1TP►�FOoS1'.�i Ciry uus.uc. ;-Zlpb (a o <br /> Address 7��-5-�- Phone/Ema���l SP,y11� <br /> TENANT BUSINE55 NAMfi CONTACT FOR PERMIT <br /> ' PhonelE-mail <br /> BI�ILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use oi Buiiding_ HEAT SOURCE: <br /> Proposed Use o(Building Gas� Electric_ Oiher_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family __Commercial <br /> Type of project: ✓New Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK�adddionai space provided on fhe back): <br /> Z�{.� � ��-A.,a Z Gla2 �'J A QA�t� , �� � `�� 3- �V� <br /> MECHANiCAL PERMIT APPLICATION PLUNiBIP�G PERMI7 APPLICATION <br /> Type oi ProJect: ✓New_Addn _Alteratlon_Repalr Type of ProJect: _New__Adtln _Alteration_Repalr <br /> Show Number(q)o/Iixfures Show Num6er(pJ ol liutures <br /> A/C-air handling units Toilet <br /> l Forced air systems Bathtub <br /> Gas iping Lavalory(wash basin) <br /> Water heater � Shower <br /> � Gas frepiace Kitchen sink 8 disposal <br /> � Gas range Dishwasher <br /> � � Clothes dryer Clothes washer <br /> Range hood ( Water heate� <br /> Exhaust fan Sink(servicelbar/mop/etc.) <br /> Heat pump Backflow preventer � � <br /> - Unit heater � Urinal <br /> — � Boiler — Drinking Fountain <br /> � Refrigeration � Ftoordrain <br /> — Wcodstove Grease trap � <br /> Ducting Roof drains <br /> Olher ,— Idedical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> ""' Numbero(Heads � Other: <br /> I�ereby cenAy I�al I have reaC antl e�amined I�is application anE know Ihe same to Ce Ime entl wrmcl.All pmvisions al laws end ordinances goveming Ihis�ype olwod va'1 be complied <br /> wAh whelher sp cifieE� rein or noL T�o grenling ol a Oermil tloes nol presuma lo give aW�orily lo violale or wncel t�e pmvision ol any o'her stale ar Iowi law regulaling wnswqian <br /> T�at I am ul� xea o e ncr ol t�is property lo pertorm IOe work lor whiUi appliwtion Is maCe enOl wmply w�l+�ho Staie Coniracton Ww 18.77 RCW anC 296.200A WAC. � <br /> Z <br /> �-Zr3-! 4 <br /> Owne AuthorizeC Agent Signature Dale (Revised 3/1073) <br />