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47$-252-1fiGG CM Hpn11NG � 04:�p.m. 10-06-201d 2/B <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERh91T SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 �wwv.everettwa.org <br /> �a -� �—/�/ <br /> SITEAD�RE'SS: ' �1, � �8208 PROPENiYTA%!t P FMIT <br /> � �th <br /> LEGAL lor new consl�ucllare Short PlaUsuhtllvision Lot No._ (���uch copy ol�ong Icgal descr�p�lon) <br /> OWNER �fA..l�,� Phonel6mall �2J �� � ' <br /> AtlAress 4 CllylSlala/Zlp <br /> APp!_ICANT: _Ov+ner _OwnofsAgenl �COnif�[t0� _ConiractafcA0an1 _Tenanllm�:i0rc+iaoaioneroimn+araimminonM.�armao+nM:�noepaol <br /> CONTRACTOR � ` (� �� Slafe Lic. #(� � Eh Bus. Lic. # ��((i0`I <br /> �dtlmss I ll�l. � Y �l�{�L61 �V� 1 OL�I Phonc/Emall[I E.�'�I��: I� . .[, <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT L�ZS ZGJC� �(G�� <br /> "Je1� �e� <br /> Phone/E-niall .L ,� �' ,VI'1 lO�l. �� C � .�n� <br /> BUILOING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exlsling Use o(fiuilding HEl�T SOURCE: <br /> Proposed Use of Bullding Gas Eiectdc amar <br /> E3uilding typo� _Singlo Family _�uplex,_Tawnhouso _MWU�Family _Commarcial <br /> T e at ro er.t: Naw nddilfon Remodel Repalr T.I. Si n S rinkler �ernalifian Chan o o(Use <br /> DESCRIPTION OF WORK�addi�ionaispaco p vrvedon�ho buck). <br /> �IO�,dU Q�0.S -�rY�GLc'Ju <br /> lJ <br /> MECHANICAL PERMIT APPLlCA7101J PLUMBING PERMIT APPLICATION <br /> TypaofProJacC _Nuw_Addn _Allanllon_Ropalr 7ypuufProJoct: �Nuw_Addn _AllonUon._Rnpalr <br /> ShowNurt�6or N o(Orturos SlmwNum6ci N o/Rxfums <br /> A/C—alr hnndlln units I Tailet <br /> Farr.nd alrs stems 11 Balhtub <br /> Gas i in Laval❑ Iwash ba,ln <br /> Water he�tar Shower <br /> Gas Greplace I Kilchen sink 8 dis osal <br /> Gas ran e � Dishwashcr <br /> Clalhos d er Clulhcy washer <br /> Ran o hood W�ler healer I <br /> Exhausl lan Sink scrvite/badmu /elc <br /> Heat wn �ackflow revenlcr <br /> Unil healer I Urinal <br /> f3oller � flrinkin Focalaln <br /> Relri cralian Flonrdrain <br /> Woadstove Grease tra - <br /> Ductln Rool Jrains <br /> Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Othcr. <br /> Nwnbcr of HeaAs � OUier. . <br /> I�mc�y corllly Ihal I havu mo�nnJ u�ominutl Ihls npP•�cil'an nnG kqmv Iho samo lo b o Irun nnd cam�d.All piavlfbne ol lavn antl oNinanco�povurn!o0 ihl�I�pn ol work Mil�o mnpi <br /> vnlhw�alnurnpnoLetlhc�!inornat Thuyr�plinpolepnnnAAoasnvlpmi.umuloplvcaWhortylo���ul.ilearu�ncclthupmv.lonolanyolhcrclNoorloryllowmpuLJmpa;n;lnid�nn <br /> That I mm��nlmitrcd 6Y V�c ownci ol ihb prupo�ty lo pcAarrt�Rm wark far which uppLcn6on le mndu ontl I comply mll�Ihc 5talc Cuntrac�cr�Lnx 79 l7 RCW ao�19c 20�A NJAC. <br /> ;� F I ' <br /> I/P.� � �� 'ln � `Y' <br /> Ownorl Ihorlxad Apenl Slmi:�Wm Dala (Rov(:atl9.2014) <br /> l:� <br />