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� � <br /> PERMIT APPLI�ATION <br /> BUILDINGIMECHANICAL/PLUMBING/S IGIV/SPRINKLER/DEMc�LITIO�N <br /> CITY OF EVERETT PERMIT SEF2VICES <br /> 3200 Cedar St , Everett, WA 98201 425-257-8810 FAX 425-257-8857 vrr�nv.evereth�va ory <br /> 51�32�$. �1 PROPfRTVTAXN P��IIT�qO� � I� <br /> '�. . $@ eJ4e-E.i,\ �'� <br /> LEGAL lor ne�,v conslruclian. Shcn P'��7suttlrvl5ion�5C/�C�`G- C A�-� lol Ko�1� (allach copy ol iong ie Jal�escriplion) <br /> OWNERSg!l�TTI--� �CAr lC_ ����5 Pnone�E�nad �LIZ.�j � 'rJ 3' Z.�Ur"' <br /> l Z o 5•..�. fzJ41�EC'r �u� N^'�`�1 G �/�,�-�- C� �( <br /> AAOress V — oo Cily�Slate�2�p �C.�u-�G,�� �� • 1�' Z.� -t <br /> APPLICANT: _Ormer _O�.vner'sP,ent _Cont�acla _Coniraclor'sA9en1 _Tenantf���.:in�c•�coa�eneioico�.s.��i��o��nea���o-��:o:.::r�.,mo:ca:ci <br /> CONTRACTOR S�Aa�L� �r;q{A� l L- State Lia rt�s*TCP�OUSE3 V Gty�us ��c.r�p3-2-�-(e "3�� <br /> n�aress SP+�_ r�naneiema.iCg 25�� ci S 3- 2$o0 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ��.�,�� �fy,,��„f'-D.�� <br /> Pnonei[�ma�l C�lS��O � ��2 - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ _ <br /> Ezistiry Use of Bwiding_ HGPT SOURCE <br /> proposed Use of Buiiding Gas `� Eiecinc_ _ Omer__ <br /> B�Jding lype �Sir.gle Family _Duplex_To:vnhousz _lciulti-Pamily _Cemmeraai <br /> T�iGe of prciect ✓ ��le�n Adtle�cn Remvdel Repair __ T i S�gn _=Spnnkler__Oemoldron _Chang? ol U;� <br /> �ESCRIPTION OF WORK(ado:uc�r+soace Frov�ced un ire eactil <br /> (LP� I N 03��Li'J <br /> ZZ�-1 P�� , Z - C.�rL �,v��c�. �3P.s � c.� - - <br /> S i3 ca c dE <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projecl: vNe:�_AAdn _Alleration_Repair Type of Pwjecl: ✓New_Addn _Alleralion_Repair <br /> Shmv Numbci(a)ollixfiucs Show Numbcr(N)ollir(ures <br /> A/C-air handling wuts '�,3 I To�let <br /> I Forced air syslems � �athtub <br /> � Gas pipm9 I Lavatory(wash basin) <br /> Water heater � Sho•::er <br /> Gas freplace � Kikhen sink A disposal <br /> � Gas rangc i Dishwasher <br /> � Glothes dryer I Clothes washer <br /> � � ftange hoad � � �' 'Natcr heaier <br /> 1_', <br /> �' � E�!+?ust(ao � Sink(servtcelbadmopletc� <br /> —� � Heat pump ^ I (3achllow preven�er <br /> — � Und heater — I Urinal __ <br /> — � E3oiler I Dnnk�ng Foumain <br /> — � Refiigera0on ..._ I Floor dram <br /> � � Woadstove ^ I Grease Irap � <br /> Duclinq � I Roof drams <br /> � Other — � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ! otnei <br /> Num6er of Heads � Other <br /> I nereoy cen�ty ihzi I have�ea7;;nd ewam�netl Ih's apD��wt�on and Lnow Ne same lo�e Ime and roircct A!I pmv�aons ol laws and ortlinances 9ovem-mg IOr lype o�work�mll6e wmpi�etl <br /> v:ilhwneltler5penf.eGheeinornal T�egranlingei�permAOoesnotpmsume�o9neauiPonty�ov::bleucancellnepwvismnalanyct�erslafeorlocalla.vre9Watngconslrudloe <br /> Thai I am a �or tl Oy e :nr�el l�is property lo pertorm�ne work Ior wMch appP.catmn�s m�e�•an�I ccmp�y e,�:�ine 5!ate Cemrar,or,La+v 10 27 RC W anE 295 20vA C:!C. <br /> �`Z <br /> fP- Zo-I q <br /> Owne Aulhonzed Agent Signalurc Dale fRevrsetl]/:01J; <br />