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PERMIT APPLICATION <br /> BI.IILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar S� , Everett, VJA 98201 425•257-8810 FAX 425-257-9857 s^rrn•� everethva �rg <br /> SITEADDRESS: PROPERTY7AXp pE 1A <br /> 2 .'3 5�-''` p2 . s�� ��J�� C��jO - D <br /> LEGAL lar neri censt'uC(iCn' Shcit r13Usub�ivu�c�5[..�.�rL \a2.�1�— i ot N�3� (at!acS cnpy cf l^na icgal Uzscnp�ion) <br /> OWNER .p,�i � 7,'���� �L. �-�UvNi�S Ph�neiE-mad q2S S 3 • �Z'�p'C7 <br /> ada�ess \ZC Sw �t� � Lk-�i MA�.- l�W. C�y/5!atdL'v �.���CJI i �.1.:�. � �1�•ZGQ <br /> APPLICANT: G::cer __O�rner'sASen: __ConhaCh'+ . Ccrlrx;�efSAyent Tenantl^",.';;.o^xa��aec�:c•;e.�:rcm9._:.�m�.00:�uj-r::e:;r_el <br /> CONTRACTOR ��Z,p:�-C��e.. �(�C�,f�L I-+ti1MrG5 Stal? Lic. #S6/�l'CPtiCC;S�3 �-' City B�� Lic. 4(,,t'7 •L�,.{,; *: <br /> Ada'es; jl>yy�l"` i�hone!cmeil S��y�� <br /> TENANT BUSINESS NA�dE CONTACT FOR PERMIT TL�{N L��wc�.�� <br /> f'hanc�E:-m:;il a�2.5 7� t "— /��C Z— <br /> BUILDINGPERMITAPPLICATION CO�IiRACTPRICEOFWORK <br /> [xi;eng Use of Bu,ld�^9_ _ HE��SOURCE. <br /> Propes>d Use of 9uildir:�_ _ Gas E!cur �,'�.iee� <br /> Buildmg type: ✓Smgie Fam�iy _Duplex_Tovmhcu;e __._tAuit�-Family __Commercial <br /> iy�Ffl�(prc�zct ✓New ___ilddiucn Fzmedel Repav__ TJ. Swn_Sprinhler Demo!�Lun_ _Ctiar,ce of VSF <br /> DESCRIPTION OF WORK/aCa!:a�a�<,uce p:criCMcn:no�acw;: <br /> � Iy03- t� 0� <br /> Z�`t o ��.� � �ra2 � 3 I�S�C_ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProlecP. _New_AtlAn _Alleratmn_Rnpalr 7ypo of ProJecY. _Now_AdOn _Alloration_Repair <br /> Show Number(NJ ol O+fums Show Numbr. i�J aI!ix fines <br /> ^ �VC -air hantliing uni:s '3 Tollet <br /> � I Forcetl au sys:ems �i CatMub <br /> � Gas�ipin9 i LavaLry(�:a;h ba=_in) <br /> � � Water heatar t___ j ShoF:r <br /> j Gas tireplace � Kitc�en sinY. 8 dlspesal <br /> \ Gas �ari�J� Disir;,a;her <br /> Clcli��cs dry.rr �--�- Ctalnas�n�sher <br /> � Range hacd �n _ _ -- <br /> � Exhaust (an Smk�servicelba�Onopletc) <br /> .� j Heat p��mp .-- I ;,ackGow prevsn�cr <br /> ; Umt hcater Urina� —' <br /> L'oiler Dmt:ny r�ountain <br /> i Refria^ralion � Ficordra�n <br /> �— � V:oodsmv� — Grrse�rap <br /> Duct�rq Roof diams <br /> � Otner — i Medicat Gas <br /> SPRINKLER / SUPFRESSION SYSTEM o!hcr <br /> � Numberef Neatl� i Other <br /> 'ne.e�Y ce�!hi Inat I huce rcad an]emrr!ned:tr.,opp!aa6�a aco Wir+iM s�me io be;:uc un1 mrrep n�.l,^rov�xens o!lanz acC af nances r,oveir.inq�hs lypo ahrvi�rP Ce co.T�pte9 <br /> w9n wl�,e:ne:spmhM rp�clm m�cl. rnu g�vn6r,y et a perT,t�>es not o:ecam^;p g�.ve au;>urtly;o vie�att oi wncel rtuu�ons�_t c:any 8^er s�ale o�I:[�I law�eg�lnloy can;'�u-i i�n <br /> 1 na:l an�ai.:r. csa�:oe o.vnu ot!n�s pmprry b petlelm in:q>;a;a Nn:nt pPP4raP4��s r.a�o an91<c.'^C:Y�din Rt Stale Cca:raeus Lr.'iE'.7 RC:i dn9 i?5 200F;YAG <br /> �� � <br /> � � �-z - Is- Iz <br /> Owf�r;AuthonzedAge�rt ianaWro Dale pevl n��^) <br /> ! • se�3._o..� <br />