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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLERIL�EMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPEnTV TA%H PERMIT tt <br /> 13 �� �. S� �J T 'LI (�— D� <br /> LEGAL lor new cor,;truction: Short PlaVsubdrvi;ionCASC-�C�rZ Pp4-�� Lot Ido.�3 (auach capy ol long Iegal description) <br /> OWNERS�L�CTL.F� ��- �(-. C"�S Phoncl6mad �}ZS �15 3�• Z�pC <br /> Add�es. , — S"`T� c�ty�siaie�zi �`LG'j <br /> � ZO ILUG ' IAW� P fLl��tfl,t� U.� • � �. <br /> APPLICANT:_Ovmer _OvmefsAgenl Conhactor _ConlraclofsAgent Tenan��m�i�pro�ae�icim�mmnsam�:onmao..nrrmeowoik�nma;parnl <br /> CONTRACTOR �4CT l. C_l � l Slale Lir,.# 3 - - 3(.p U Cily Ous. Lic.#$FAi�la � F <br /> Adtlress S�y�L Phon�/Emdil �u+�FVti� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT J-p�i.�j U�k�S'�tj(ZL <br /> Phone/6mail ��Z�) 3S�f'- 4��-' L- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK _ <br /> [xisling Use of Ouilding HEAT SOURCE�. <br /> Praposed Use of Bwiding Gas�Cleclnc_ Olher__ _ <br /> Ouilding lype: �Sin91e Family _Dupler, _Tormhause __M1�tulli�Family _Commercial <br /> Typ�of projecL '�New _Addilian _, Remodcl __ Repair__..T I _Si9n Spnnkler_Demolit�on__ Change ol Usc_ <br /> DF_SCRIPTION OF WORK(advnm�re�spacep�ovitleUnn�heUace)- <br /> Z�-o 5 �z c� �, ,�.���s� � ��►�5��_ QZ3�403 - oo � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Pro�rcC � New_AdAn _Allen�ion_Repair Typa of Projoct: _New_Addn �Alleration__Repair <br /> Show Number(dJ ollixfures _ Shovi Num6er(p)ollistums <br /> � A/C-air handling und; 3 I Todet <br /> � � � Forced air sy;tems E3athtub <br /> � �;�5 ni��i��� — /.� Lavatory (wash basin) <br /> \ � WJII'.f I1CJ�Cf _ I I Shower _ <br /> Gas fuep�ace \ Kitchen sink&tl,posal <br /> � Gasranqc � Dishwasher <br /> � � Clo�hes dryer � � Clothes washer <br /> � � Ranyc hooJ 1 I Nlaler heater _ <br /> � Exhaust fan 1 I Sink (scrvicclbadmople!c.) <br /> � Hcul pump '— I Backflow preveNer <br /> — � Unit hcaicr — I Unnal <br /> _ � --�{oi��� Drinking Fnuntam <br /> --- Refnqcration � - .----- ^ Ploor drain <br /> I Wondslovc I Grease�rap � <br /> -----�Duclin9 --- —....— — i Rooldrains <br /> -----'- � Olher __ _— A9edicalGas <br /> SPRINKLER I SUPPRESSION SYSTEM — � Olher <br /> NumberofHeads � � Other <br /> I I:ciebV r.enlly ihw I hnvc rca�l nnd c�am�ncA IF,:appi:caton and knon Ilv:soma ta bu Ime anil rnned.AH piom:ian:ol la�v;:mtl o:�:n.mces 90�imnir7l�::1y0"�Iv:o�k w�ll�c mmp'.mtl <br /> �v�pwlrotiv�/:fecPmJ��rrinornel Tlm9ran��ngnlapc�mu�m�snolpresumetnqivc:mmociymvioni�corr.�nccliMpmvi:lonolanyolhcrstalcr,rlooilia��requl�l++9cron•erur.tlnn <br /> Thal I ain 'I�wi by❑ ovmet I m;pioveny�o priinfm i0e wmk lor wnich aOPhrtllon I;in•We znJ 1 mmply wi0�Ihe SINe Conlrac�ors Lan IB 7717C1V and 75u 2P9A WAC <br /> �' �Iz <br /> � 1z G.-i q <br /> I Own r�u���orizeJ Agcnl Signalure D�do (He�ncad','R019J <br />