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� � <br /> PERMIT APPLICATIUN <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRiNKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St_ Everett, WA 98201 425-257-8810 FAX 425-257-8857 S^n+nv everer:va.org <br /> SITE ADDRESS: �rWOPERT�x�� P� "�T'O _ � " <br /> 3 Z� `� 'Q(� . s� . 'tc�L�iT <br /> LEGAL lor ne:�ron;trethon Shch PlaUsuhdvision G45�AC��s'�lel No�� �anac•i so,y o!i;ng iegal de5crv.pPen) <br /> OWNERSEPTTI.Ft �l��C- �C�'C—S Phon._�E�mail <br /> iZo S�I u�4tf�f Wb�.t k+A--{ -- <br /> Pdmezs SULTF'c. \00 C�IYIS!ate�Z� - �,�'j' ln�i . �1�2DQ <br /> APPLICANT: _Ovirsr _0+:�•er',Fg=nf _Cenlratlm _Con�tadoi5�1gen1 _lenanlP-�:�p:o.��•,�.�.'i,�c'ccr.ser.rm.nm�,o.,�e:roCo�.,on����na+pacn� <br /> CONTRACTOR 'S�y4tt�l� PAe.�i= �e.- siate uc ;SEEa�i Ho�'S6 U aiy s;,s ��c u(Qp3-Laa�o 3Teo <br /> Fad�ess SAv�n�-L . Pno�e�em�� 4LS 953-Z�ac� <br /> TENANT BUSINESS NA�9E CONTACT FOR PERMIT ��� f n^�„F�Z� <br /> Pnon=ie�ma�i L42S� 350-�OoZ- . <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Fristing Use o(P.wid;r.� HEAi SOURCE� <br /> proposed Use o(F3uJCing Gas ✓ Electuc_, Oth^_r_ <br /> �u:!ding lype. �Sicg!=family _Dupiex _Tor:nheus? _L4uIlrFam�.ly _�cmmzr:ial <br /> Type o(prqed '�tle:� Adddicn Remodel Repa�r_.T 1 __ S�qn____Snnn�@r_Demolition_Char�: nl Use <br /> DESCRI PTION OF WORK(acd�ronai spsc���n:�ced on tne eackl <br /> �Zo�� i��� z- c..�2 c,���-• �. 3As� � ) <br /> s bC3 orJ �.q�l'�. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> T�pe ol Pru�ect: Nc��v_Ad�1n __Allcralion_Repair Typc ol Project: _New_Addn _Alteration_Repair <br /> Sho�v Numbcr(N1 0l lixfures Show Numbcr(#)ollir(ures <br /> NC -air handling umts I Tadel <br /> ( I Forced a�r syslems I �alhtub <br /> � Gas piping —� I Lavatory(wash basln) <br /> —� Watcn c�atzr � Shower <br /> i � Gas freplar.e _ � I Ki�chen sink 8 disposai <br /> � Gas iange -�� Uishwasher <br /> 1 I Clothes dryer ' Clothes washe� <br /> �—� Range hood ' Water he�ter _ <br /> --j [xha��sl lan , � Smk(servicelbaCmoPletc 1 <br /> �— � Heat pamp .— I E3ackflolv p�eventer <br /> � Und heater I Urinai <br /> —�- � BoJer -►- I Drinking Founlain <br /> �. Reln9cration �` I Floor drain <br /> � � Woodstove I Grease trap � <br /> Ducbng � Roof drains <br /> � Other I Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Olher <br /> Numher of Heads I Olher. <br /> I Oere�y<en�ly�Oai I have�eaU antl e.am:ned thi,apC�i<atian acd knaw Ihe same lo Ce ime and coiretl A!I pmvisicns ol lav.s and artlmances gevermng 1Hs typ�ol�:.o�k wll be ccmpSrd <br /> �nln nheiher spenfmd nerein or r.ot.Tne granling cl a permit Jo^s noi p�esume lo qrce autnonly lo vi:la!r or car,cel lne provision ol any ather sta:e or Iou�l�xv.iegulaling consta�ceio� <br /> 7hal I am am n_e OY' o: er ct i�is pmperty to per(orm the work lo�w�ic�appf:caiion is male an0 I cemp'y wn�i�e Slaie Cu���iaclors La.r IB 27 RGW ana 255 2CCA WAC <br /> � `'� <br /> (o- ZO--� �' <br /> Owned horized Agent Signaturc L'a�e (Rev�sed J/2017) <br />