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� • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/P�UMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WFl 98201 425-257-E�810 FAX 425-257-8857 N�v.evereltwa.org <br /> SITEADDRESS: 1+ P::OVERTYTAxa PE • T _O <br /> C( "3� — �-�� � SC"z �J4.Lh.Z� <br /> LEGAL br nen conslrcclion: ShoA PlatlsWdivision ��.Ad�—\Nl.k-- Lol No.�� (allach copy ol long tegal descriplion) <br /> OWNERS�R���—� p(i�.lF�Cr iT�NI PhonN[-mail Z5 qs�" Z�7�� <br /> Addiess ZO S� �j � yW}�. VWa City/SlatelZip � ( �A.k/k. 1$Z� ` <br /> APPLICANT: O�.vner Owner'sAgent Conlrac�or Canlractor'sAgeni _TenaN(�n��:ipro�;d�:�ie:eicimn:enirrammoo,.��.P�ioeowc,ininecp�ce� <br /> CONTRACTORS�P6Tl_FC. Q({.ClL(-lC— L�ov►�� i StateLic. jVvk0oST3�1 c�iye�s. uc. ;(eo3•Z!c(a ��o <br /> Address `j�+,y�.��. PhonMEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �'�.�.N ��aqfQ�� <br /> Phondf_-mail QZ� �3 S d �' "��1" <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ���L�O .O _ <br /> Existing Use of Building HEAT SOURCE�. <br /> Proposed Use of Buiiding Gas_✓ GleGric_ Olher__ <br /> Building lype� ✓Singie Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type o(projeU: �Jew Addilion _Remodel _Repah _T I _ Sign_Sprinkler_Demol�tion_Change of Use <br /> DESCRIPTION OF WORK �addrtmnai sp:,ce mo���cn m�u�o nack)�. <br /> 2'c7�1 O � 17��r—� I�P�S��- P L� S�3.3 w��� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> �ype of Projr.cL• _New_Addn _A�leralion_Repair Type of Projecl:{�Nev�_Addn _Alteralian_Repai� <br /> $ho+/Number(8)ollixfures Show Numher(H)ol lixfures _ <br /> �. —� NG—airhandlinyunils I io�lef <br /> � Forced air sysfems � Baihlub <br /> � Gas pipiny � Lavatory(wash basin) <br /> � � Waler healcr � Sho•r�er <br /> � Gas lireplace � Kilchen,ink C disposal <br /> ,----- Dishv+asher <br /> �_ � Gas range _ 1 � <br /> � Clolhes dryer � � Clo�hes washer <br /> � � Rangc hood —1'��� <br /> _� � Pxhausl fan _ _� Sink(scrvicelbadmop/cic.) __ <br /> Heat pump • � 6ackliovi preveNcr <br /> _, � Unil heatcr � � Urinal <br /> � 13oiler � Drinking Founlain ___ _ _ <br /> � Refn9eralian ._._ Floordrain <br /> � — � VJoodstovc Grcasr.lrap <br /> � Ouc6ng _ � Rool drains <br /> � Olher .— � Medical.Gas <br /> SPRINKLER I SUPPRES510N SYS i tM — � Ou�er <br /> � Numbcrofl-Icads � � Olher <br /> I ncrcb/cc�iJy Inal I hauc ica9 anJ c.�mined Ihs:�4PLcabcn nnd kno:i Ihe:ame lo Gc Imc and mrmcl All piavr.ion,ol lavrs and oidmanccs 9wermn9 i��s lypc ol woik wdl be mmpl ed <br /> �veh wheRre�;p��6lietl Ic�irim m�ot 7 he granlin9 0l a pcimA�oes nnl presume l0 9ive aulhou'y lo violale a�canccl ihe provisicn ol any o�hcr slalc ur local law iegWabng consimclion <br /> Tnal I am aNhodre y�I o:�nrr ol lh�s properly Io peAorm I�c vmrt IDr w"�ittl apfl¢alion i;mntle an�l I CornplY�'+�I�Ihe Sla!e f,on'racrois La�:i 10 27 Rf,W antl 79G 7.ODA VJAC <br /> _ �( v <br /> �, � I= aq - �q.! <br /> - -- — ---- ------- <br /> Own AuthorizedAgeniSiqna�ure Oaie (17evised7/70t7) <br />