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G aC1 <br /> PERMIT APPLICATION <br /> BUIL-DING/M ECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett.WA 98201 425257-8810 FAX 425.257.8857 www everettwa erg <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX a FERMI o -01(DI <br /> LEGAL for new conslrudmnnJ short Piatisuodwuton Lot No t_,,R[ (atlach copy at long logo?demnphonj <br /> OWNER/—eO -YyL PhoefE•mad <br /> Address CnylSl3le2lp 3Ao 1a3 <br /> 'g <br /> APPLICANT:_Ownor _CnenersAgent KConlractor <br /> CaOimCto/e Agent t Tenant ltwru•n.e.•weu Mum•n sem a••wvae•wnadw q.r•I <br /> CONTRACTOR A " r •• L 81 Llc a_1 J�WV�V" S9L COE Bus.Lit #�71J493 <br /> Adoress ! 1715 North Creek Parkway Ste C-106 Bothel-l-,-W�A 980[7�1� PhonofEmaa (yl oor�a crtwa�.(d <br /> TCNANT BUSINESS NAME TAC OR PERMIT <br /> u2� 1t73� <br /> phanelC•mu •[ <br /> BUILDING PERMIT APPLICATION 1CONTRACT PRICE OF WORK &5 <br /> Existing Use of Building HEAT SOURCE <br /> Proposed Use of Building Gas DOOM Other__. <br /> Building type. __Single Family _Duplex_Townhouse _)�Mull4Family _Commerual <br /> Type of project. Now Addition Remodel Repair T.I _Slgn Sprinkler Dominion Change of U_sc _ <br /> DESCRIPTION OF WORK(additional span provided on the back) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typeol Project _New_Addn _Allarailon_Ilip,w Typeof ProjeCt _New_Adan _ Anerelmn_Repan <br /> Show Number 0)of fialura _ _ Show Number(l)of nrrures <br /> NC-air handling units _ _ Toilet <br /> Forced airs stems Bathtub <br /> Gas piping _ Lavatory(wash basin <br /> Water heater __ Shower <br /> Gas fireplace Kitchen sink 6 disposal <br /> Gas ran ls _ Dishwasher <br /> Clothes dryer _ Clothes washer <br /> _ <br /> Range hood Water hooter <br /> Exhaust fan Sink seNlcelbadmopfetc) <br /> Heat pump Backltow pieventer <br /> _+ Unit heater - Urinal <br /> Boder Drinking Fountain <br /> �—Refrigeration Floor dntn <br /> i Woodstove _ Grease Ito <br /> Dueling Ron, drams <br /> I Other Mad?cel Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other <br /> Number of Heads Other <br /> 1 herby tent/that I nave tone one tramMte pin soDE[al'wl and Mew me fame to Dt Irpr•nD[one[/NI pronaana nl yws and e�Un Nql aovBnnp Ih s ryyn pl won m1 De romDwtl <br /> win whelnw iprtlad ne•nM or not The namNo of a Prime duet not pre Wna Io ghe nuthoen io rioNln pr Un01 the D.A.otonp D!hri ea•.. teneNtlwn <br /> loot I am aWhemetl eY ten owns ulInn PIOPrIN m Pham the wore IDI wh'dh oppruton IS mean aid I wmpY wih the Sum Cnneattas I owin 22 nC W aId Jet 2 WA['rAC <br /> ONtt2-72v6 <br /> 410,10,1.14NIOA nnt Signature IDole Ilfer'M•d f✓7012) <br />