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PERMIT APPLICATION <br /> BUII_DINGIMECHANICALIPLUMBINGlSIGN/SPRINKLER/DEMOLITIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cea St , Everetl, WA 98201 425-257-8810 FNC 425-257-8��i www.e�zrettwa.org <br /> SITEADDRESS: Paor[anraxa PE(i rtt ( <br /> ct� i1� '-�.4 L12. Si 7��rc,L1 O ^ Q 1 <br /> LEGAL far neH conslruciwn� Shvrt PlaUsu�dvisior�„��A C�G t�A21�- �oi NoZc (atlact�topy of long tegal CescripUon) <br /> OWNER •�O.,i[L,� �Q,L�rI(_. �-�OVV1rGS PhonclEmaJ qZS��3 " Z.�Sd'� <br /> ndo�ess \'Lp � � -Z� �..ti MA��- WA GrylStai�JZio �.,1��� U..�4� • 41'��C� <br /> APPLICANT:_Owner __C,vnefst.genf _Contraqor _.ConLactar's.lgert _T�wntl�'�r�.���•:oaermw-,wmi:aneo_,.,�,e:�dv.m:�:w.ca�t <br /> CONTRACTOR S�Z,/�'-CL�� I�C..�F -� �GS Slate Lir„ ?f$�p,TCP�i 5'(� l� .City 5us. lic. #(at'i-ZC�:1�, <br /> t,deress SA�MrC, �no�e/era�i SAM1L <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �C�N (� D^wcJ•LG� <br /> Fhone�E�ma�d LlLS 3Sc� - 4�o z.- <br /> BUILDING PERMIT APPLICATION CONTRAGi PRIGE OF WURK_ <br /> Existing Use of Building _ HEl�T SOURCE: <br /> Proposed Use of 6miding__ �as__ Electnc___ Omer_ <br /> F3uilding type� ✓Singie Famiiy _Duplex_Townhouse _tdulti�Fam�ly _Cernmerc,al <br /> Type of pro;ect� ✓New AdCilion Remodel Repair___TJ Sign__Sprickler._�emolition Change of Usc <br /> DESCRIPTION OF WORK(eacarona�space pro�rdev on tne Cack)� <br /> ZG-1 O ��.r�.;v 2�-1�2 ��av.�ie.. �3ASic:., � R.6 i4o'3 -cr�`l <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projocl: _New_Addn _Altera�lon_Ropair Type oi Project: _New__Addn _Altoratlan_Repair <br /> Show NumDcr(p1 0/fixfurts Shaw Number fb)or fiYtures <br /> �'- NC -air handiing units '3 I To:let <br /> I Forced air systems I �athtub <br /> I Gas G� in I Lavalo (wash basin) <br /> I VJater heaier I Shcwer <br /> Gas 6re lace Kitchen sink 8 di,posal <br /> I Gas ran�7e Dish;�ashzr <br /> i Cloflies tlrye� � Clolhes waslier <br /> � Ran c hood � W�der hualer <br /> [xhaust lan ; Smk(service!badmopietc) <br /> + Heal pump � � Backfiow prevenler <br /> � Unit hea�er Unnil <br /> I Boiler - Dnnking Fountain <br /> Refrigeration � Flocr drain <br />� • I Woodstove — I Grease trav <br />� � Ductin ! Roof drains <br /> i Other — �ded�cal Cias <br /> SPRINKLER / SUPPRESSION SYSTEM O�ner <br /> Number of Heads I Other: <br /> I�emCY�ert3y Ihat I num rca�an0 e.artuned Inis�ppl:atron and Anow Ine sama io b�Ime anA mrretl All o�ovivc.�s o/in�..s�ntl o_inaMee govemmg Ms trpe ol wcik+GI De rom�veC <br /> •e-�n wTemer speclietl neiem or nal.T�n grnning ol u Certn1 does nol prusume ro givu ovVmny lo vk�.ute er eiactl��v provl:vf ol any cJ�er siTe or lo;,al 4�w rcqutaung conswdron <br /> 7�ai I nm a�vA Oy i�e wmet of fn�5 4vopetty Io perlMn Jie work Ic�wtil:t�apptical,on is maEe and I compiy x�L�Ne Sta'e ConUatlars Lew 1 B 17 RCW anE 2`.�6 200A N'4C. <br /> �� � ��� <br /> \�� �J�(Q"l�_ <br /> Ow rlAuthorized Agent ignature Dale (f7evised J?019) <br /> I �' . — . _.__ . . __.. ._ ___. <br />