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� � <br /> PERNtIT APPLiCATIOfN <br /> �BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 �vww.everettwa.orq <br /> SITE ADDRESS: 1 K � _ PROPEf7TV TqAN . AER�dITN <br /> _ tJ2_. Srz ,�����i � G �liz- <br /> LEGAL for new construciion. Short PlaVsubdivislonl.A$C:'>�f"L- P�-�I�� Lot No.`�1 (attach copy of long legal descript�on) <br /> OWNERSFC.�iTI-�Z-- PD.LI�� �C-- "�O ic.-S PhonelEmail �ZS� CIS3-' Z.�iC�Q <br /> Addiess ZC � ' ILIY. ' L1.41 SU�o 'c��Y�s�����z�p tzJ4�.�c.�.i �.lA� • -lU� zC� <br /> APPLICANT: Ovrner _O�aneisAgenl Cuniraclor _ConVaav'sAgent 7enanl(m�sic�o�meaienectoo�:emuommoo��.��c�mdou�oitimm�„v��ol <br /> CONTRACTOR �41T U � � Sfale Lic. - 3 - , ���PU City [lus. Lic.N$FA��N �_ r <br /> nddress Sl�vV11L Phonel[mail S�Nn� <br /> IENANT BUSINESS NAME CONTACT FOR PERMIT �-Ol'� G�h W'Y> — <br /> Phone�Gmai� L L�� 3S G•- 4�CZ <br /> BUILDING PERMIT APPLICAYIOYd CONTRACT PRICE OF WORK <br /> Exisling Use of Building HFAT SOURCE�. <br /> praposed Use of Building , Gas�[lectnc_ Olher _ <br /> Building IyGe ✓Single Family _Duplex_Tov:nhouse _A4ulli�family ._Commercial <br /> Type of pwjecL �Nev� Adddion Remodel _ Repair_T.I _Sign_Sprinkler._._Demolition_Change ol Usc <br /> DESCRIPTION OF WORK(add��ionaispacef�nvidedoninevacR): <br /> �Q-1 O �1�Lf�) � Lra�2 g!_ut>.�� ` 31�S1L �rl.'� \ �173 - ��� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ype of ProJecl: N✓ ew AdJr� _A��eration_Hepair iype of ProjocC __New_Addn __Alleration_Repair <br /> Show Nurnhcr(p)o/�ixfuics Show Num6rr(A1 01 lixfures <br /> � NC-air hantl�ing units 3 ! ioilc� <br /> I Forced air systems Z Ualhlub <br /> � Gas pipm9 /.� � Lavatory (wash basin) <br /> � Waler healcr 1 j Shower <br /> Cas lireplace \ � �.itchen sink P�disposol <br /> Gas ranqe � � Dishwasher <br /> ( 1 Glolhes drycr � Clothes viasher <br /> �_i� Ranqc hood �--Vdater healcr <br /> �_ [ahaust fan 1 I Sink(service/baUmop/elc.) <br /> f Ical pump '— I Hackllow prevenler <br /> — � Unit heater � Urinal . <br /> _ � �oi�e� _ — Urinking Founlain <br /> — Refnqcradon _ Pluor dram <br /> � � Woodstove __ — � Grease irap � <br /> --� Ductin9 i Roof drain, <br /> � Olher — tdedical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM — � Other <br /> Numbcr of Heatls � � Olher <br /> I nc rrhy ccnlly Ihnt I haw rentl ind evnmineA Ihi:npp!IcaGon and�row Il;n,art�.a lo hu!me and c.mrucL All p�ovi^.on:ol law:onJ oitlmance:qovemin9 Inis typ^ol�vo:k vdl be comp!�,etl <br /> e�I4 rArelh^r rpeclhed hetein or nol.ihu 9iar:��ng ol a 0^rm�l tloe�nn�piesume l0 9ue avlhooty�u vmla�e or can[e�ine piov�sinn ol 0ny olher;lale r,r 1oe91,�n rer�ulal ny consln¢Ilo� <br /> inal l am+ 9iont 9 by�o:rner I tCis piaVerry lo pe�form��e rmrk fm r�hicli oppliwlion�s male enU�cemyly ei:h!he 51aie Conlraclore Law 10 D RCYJ an�390 2C0A WAC <br /> - ,-z.- � -, q 'l� <br /> Own r Au�ho�ized Agent Signalure Dn�e (ReviseJ 3Q073J <br />