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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wv�nv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � S � <br /> SITEADDRESS: J PROPERTYTA%N PERMIT# <br /> I ',3:'� j?,t l (.�1,ive S� 2 •.o->�`�cx.� lo�� a, C � Z. ;c . �c <br /> , <br /> LEGAL(or new constmclion: Shod PlaVsubdivision ��'l(t `i11�c' Lot No.� (allach copy of long Iegal description) <br /> owNeR lC'i1�1��� Il,��tit11�6J��f Pno„aE-ma�i 253 S9o;1�c 5 �tix°u�IC: . ��n�Sl��clt�C F� <br /> �rrncc� cuY� <br /> naa�oss f��IS CCVt t�'� 1�'Ll f SFF cryisia�crz�p l�ll� CtiL' ? Cv/j �I �S/� <br /> APPLICANT:_Ormer �Owner'sA9en� Conliaetor CoNraetoisA�ent _Tenanllm�.,st��o��aoeieve�oic��semimmme�..��crioao�.c�k��me�poml <br /> CONTRACTOR �111 1Q 1:O��L f�1.'6''� — L E I Lic. il L�/U/J�/��i i��� �C COE Bus. Lic.# <br /> < {?,C{ C Sr � �a nU✓ i,��k �I�-�7.> Pl�onclEmail '�.53 370 =';�%5 . n <br /> nddressl��Si_> CCl,lycv� 7tc hi �'-n-yY'�tl . it�tuc�(Dr <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT M��,�t.. 1.�+n Sj��IWk <br /> .11C�;.� K: . Vi"��`-JiCl�' �c�(E'nrcz� ,ca.-t <br /> ��•� PhonerEnrill J ?,$3 J`� .�JJ <br /> BUiLDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Buiiding �� HEAT SOURCE: <br /> Proposed Use of 6uilding 5�1� Gas � E�ectric___ Other__ <br /> Building type�. �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T pe o(pro�ecC �New _Addition Remodel _ Repair_T.I. Si n Sprinkler Demolition_Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ����./Lu.C1iC'� � Cti /1P�� �f/° . I"�Illn ����.L � ���-YtI�CY� r � <br /> � I'��.�>iC ������ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of PmjecL• �[New_AdAn _Atteration_Repair 7ype of Project: �New_Atldn _Alteralion_Repair <br /> Show Num6cr(N)ol/ixfures Show Numbcr(q)o/Iixfures <br /> j A/C—air handling units Toilet <br /> i <br /> Forced�+ir s slems � Bathtub <br /> U Gas pipinq � Lavatory(wash basin) <br /> Water heater Shower <br /> Gas firzplace i Kitchen sink&disposal <br /> Gas ran e 1 Dishwasher <br /> Clothes dr er Clothes washer <br /> Range hood �����Wale�F—ie'2tar" <br /> Exhaust(an Sink(service/badmop/elc.) <br /> � Heat pump C,' Back(low preventer <br /> > Unit heater Urinal <br /> - Boiler Drinkin Fountain <br /> �-� Refri eration Floordrain <br /> Woodstove Grease trap <br /> � � Duclin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Other <br /> �- <br /> , NumberofHeads ' -- <br /> � � <br /> I hereGy corbly Ihai i nave reo�and examinetl Ihis apOhcabon an<I l.now Ihe s�me Io be ime and co�recl Ali pr � � I � 5 goveming th yp �wo�k will be complie0 <br /> ..�.r,:nNn.cspi::i���..JhercinornotThegrantingofaDe:mrtdoesnolpresumetogiveaulM1ordytovioiateor<a t rovisionolanyolnerstateorlocala r� ImgronsWction <br /> i rn i:un;��.a��c:r�::�.d n/Ine ownerol ihis pmperty lo pedo�m Ihe work lor whic�appLwtion is matle antl I cnmpl ��y�fy S�at C�I�cto0rs�vht9�RCN a 200A WAC.� <br /> ; ' M ��, <br /> � � ` 1� G��.�.� Qti�Sl �� il <br /> ��� .�l�i 1�3 �+ T.� �r �v�� N� � <br /> OwnedAuthorize genlSignd[ure� Daie v�t�J 1f SQ����C'��-_� ised6.2072)� <br /> rm __�- -- <br /> �,.. _- --- - <br />