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Fr�m: iai ���2o�2 o�:2a r�72 P.0031007 <br /> C�b`16� v <br /> PERNiIT �PPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITIOtd <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, WA 98201 425-257-8810 FAX 425-?_57-8657 �mw everettwa.org <br /> APPLICA710NS ARE ACCEP7ED FROM 8 AM TO 4 PM /G � �9 ` (� <br /> SITF.ADDRESS' �ROVERTY Tnx rt P� �+��T <br /> - � - - — � � _ G� , <br /> � � <br /> LEGAL lor new cons:m[�mn Snan F I�VsuCtlrvisir.n __ lo�No___ (��«�����PY ol�eng lege�tlescnptlon) <br /> OWNfR —p 7 � � Phcnc�E-mail � — L� LZ— 1 ��`� <br /> r /� <br /> AtlOress �� � w •. CIIylSlatelZip — �"l V <br /> APPLICANT: __Cvmer _O�+ne�sA9ent -pConlmclor __Cenlrauor's�gant _Tenant�m:.�p�n.��:�,kiu�cicc�u����=nmeo.nnn:ca..�n���i�c.w:•1 <br /> CONTfiACTOR - ���.J"� �iC� r c-, L 8 I Lic.ri t ��1�'J�i��IL��u�J�-CGF_Bus. Lic.tlCj�' �—j 7 <br /> Atltlress �L�C� ��� � IV� �� �� F��C����.�� 1 O�'J� P�OnCIEma:t m� � [ ��J� 4JQ�C� ��f(l��-���i' 1'A <br /> TENANT 6US WESS NAME CONTACT POR PERfd1T ��c)1� �j at—p�l <br /> u2`7"�L�7"-���. <br /> NnondE�mu".��('•V:ij7C������0�'S .u'PS .�PJr��� <br /> BUiLDING PERMIT APPLICATION CONTRACT PRICE OF:�'OR'R <br /> fxisllng Use oBuitding _ HEAT SOURCG: <br /> � <br /> Proposed Use of Buildinq �n! p fas . _ Elec�nr. .._ Otncr___ <br /> Buildmg type: _Sinc�le Family _,Duplex Townhoust _Mulli-Famiry _Comrnercial <br /> Type of pmject New _�tltlition _Remodel _Repair T.I. Sign__Sprinkler,_,Demolition _Change ut Us� <br /> DESCRIPTION OF WORK(eaamonai space n�ovided on u�c 6ack): �� <br /> �e.vu,ou� � (��'-�la.� c�a,� i��n_�x ti'��- <br /> MECHANICAL PERMIT NPPLICATION PLUMBIN:. PERMIT APPLICATION <br /> Type ol Pro�oct: _Nuw__AAdn _A��cration_Repalr Type ot Prcfc[I: _New_Atltln _Alterallon_Repair <br /> Show NumDcr(H)nf firlures Show flum�cr(u)of lixtwes <br /> NC—airhandlin units . Tuilet <br /> Porced air s stems i 13aU��!ub I <br /> Gas pipin Lava�ory(wash basin) � <br /> — � Water heater Shower <br /> Gas firep�aca Kilchen sink 8 disposal <br /> i Gas ren e Dishwasher <br /> — Ciothes tlryer Clolhes washer <br /> Range hood I Waten c�ater <br /> � Exhaust lan I Sink(serviwlbar/moploic.) <br /> � Heat purt��D I Backflow preveNer <br /> Unit heater � Urinal <br /> Boiler Drinking Founlam <br /> Refri era�ion • Floor drain <br /> Waotlstove <br /> � Grease trap <br /> � (:uctinq Roof drains <br /> Other M14etlical Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM Otncr: <br /> Numbcr of Hcau; Other <br /> ;LeieLv�«rl�v Ih:tl I l,a.o���a cid e.e,r�uN t:n appceLcn m'.a�Mw R�.0 ean�e lo Le I�uu:mJ cmruq.nP provu:o�m ol laws�P]orainanees Gevornm0����s t�ue eln'orr.wll un eom^.fen <br /> rvnii nneinin fi�«R����'��'rcn or noi T�.e prpql r�p oI n UormA�oCs nol V��Yun�e to 8���'e ncll�only b ri9late e�cnncul�ne pmvbun cl any pine�stule o�loca�law reB�;u�mp ccmlNclbn <br /> i i�„�!I nm uulhauxeJ�y If�u cencr u'nw propmty lu pudunn Il�c wmk lor w�kn upp,icmion is matlu ana I ccmpN w�,�+����Staie Conlmcmn Law 18 2)ItCw vn�]942BGl�W.'.�. <br /> � � � � � � � <br /> , <br /> qr } ullmrizod�c7ont 4lgnaluru �ato (Ruvfsetl ER012) <br /> �� <br />