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PERMIT APPLICATION <br /> BUILDINGlMECHANICAL/PLUMBING/SIGNISPRINKLER/DEMO'LITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl, WA 98201 -425-257-8810—FAX 425-257-8857—www.everetlwa.org <br /> A?PLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> $ITEADDRESS: ^ PftOPCfliYTA%JI P�RktITN�� V� <br /> � V� <br /> LEGAL ror new conswuien�. Short PlsUeuMroiaion Lol No_ (ahnch coDY oi bno icp• �cripuon) <br /> i <br /> ONMEF rr�.�� '�/A r � PranNE•mail <br /> nodress / �/J /. � S� euYisimdz�p � <br /> CON7RACTOR �za�r�.�� L&I LiC f! .5(�qTC% C � <br /> oarose . Yj� �L� l'/ 5`f �y�l ��c l.C���i• ���'(�.j cnone�Emon �. 1e..7i L� Ll�� �C <br /> T NT 9USINESS N G CO A T OR PERMIi <br /> ���,��,..- ,��.,5,�-ti zp� Y70 -�'3c�� <br /> vrrone�E•mall Z — Z_— Sa� � <br /> BUILDIN6 PERMIT APPLICATION CON7Rl�C1 PRICE OF WORK ^ U <br /> Exisling U50 0(Building HEAT SOURCE:� <br /> Propo9Ctl U5e of Building Gos Elecine Other_ <br /> Bullding type� _Single Family _Duplex�7oNnhouse _Multi•Family _Commcicial <br /> Typp of pmjecl: _Ne�a _f�ddition _Remoclol _Repalf_T.1._Sign_Sprinklar_Oemolillon`Change of Use <br /> Deeedpticn of Work(add;Nonoi spaco proWCed on rne pBcu)�. <br /> �r,,� �z�:.�ii,�� �!,,>,.� 6�,,� u/ �s �=�� ��� �. f'�•�'��-� <br /> Have y0U eWAad workinp wllh0ut 0 p6rmil7 _YES __N(1 C��� ��� • ����� ��1 �/ F���Li� <br /> MlCH4NICAL P�RMIT APPLI�;ATION PLUMBING PlRMIT APPLICATION <br /> ry�e oi pro�ocr. ,_r+m�_nod� �n.rauon_nouao- Typn ol ProJact: �New_Addn _�It�re�lon�Repnlr <br /> ShawNumMr(Y)O�I/xfunt 5/mwNum.�ar � ol�+'tur�s <br /> A/C-atr hanmin unils Toilel <br /> ForeoC air s slams B�NtuG <br /> Ges i irc Levato wash basin <br /> Wntur haatnr �! Shower <br /> I Gas�ne lace Kitchen sink 8 di5 osal <br /> I Gos ran e I Dishwasher <br /> CIOIhCStl Cf I Clalhesw35�!'f <br /> � Ren u houd i W:.:er hedl0� <br /> flxhaust(an I Slnk 15enicclbarlma fetc. <br /> � Hent �m � Backnow proventer <br /> Um�hex�er � Unnal '� <br /> �oilm i �rinkin Founlein <br /> Re(n ernUon Floortlrain <br /> Wuodstovx Greoso tre <br /> � Ductin Roo�tlrdins <br /> Olher � MedicalGas <br /> SpRINKLCR / SUPPRE3810N SYSTEM omer. <br /> � Num6er ol Heads I Other. <br /> I nere�y fiftliry!nnt 1 hove reatl ana ezamired�hin epplicahon ana know tho snme lo be Irue ana corrocl.All orovislone o��evr�an0 o�dmances govemmg <br /> WE Iype al�wrk ComplieA v.i�h wfi ifleE�eroin or not The gmnllnp of e pemtlt aoos not prosumc to qivc auNOtlty to v1o411e o�centtl <br /> the pro� ol any ot �JMTEor Ia,ei low mqNeling na1�UCl�On pf 1�9 nBRYlI1dMa Ot COn9SrVC110R Tn9I I Blil dOthOfi2M Dy�h8 V.�TC�C�(hi9 PfOpCI(y <br /> to orm Ih�wo� aTicn aGP�ICAtlon is mode apG Comp1Y vA�h Ihe S ele C NrNctora Law iB27 ftCW antl 4bb.P00 WAC <br /> /`� ,=�-� yr3�aa� <br /> Ownor/Autho -Xbmt9lpnaturo Dalc / (PeNsetl7lt07f) <br /> �'SS1 U -X� � ) -- Ca!/ j'-� N.�r�./' C�-� �J <br /> r`� y zs--�f�z- 5���' �" / oS- <br /> «�d [4E'.N[.�7GZt� •��=RtOS7EVS7b dW31V3S LE'80E1-60-1tOZ <br />