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^r 08111112012 12:25 #899 P.0021002 <br /> 6o ►N6 y <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SP RINKLERMEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES 43•-13--1Z <br /> 3200 Cedar Sl., Everett, WA 98201 425-257-8810 FAX 425-257.8857 www.everettwo.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROPLRTYTAk P 7305 C)Tc <br /> SITEADORESS: _ We Q T'1 V <br /> LEGA for new conslrucllon Short plausubdlv'slon V Lot NoI'll .__ (eltecngqcoPY of lora legal dcev'Dt'onl <br /> PtwlwyE-mail O:J <br /> OWNER <br /> Cltyisla1d21p <br /> Addressr <br /> APPLICANT:_Ownm _GYmors Agent +y d <br /> Contfelrtor Contreci 's Agent _7¢nsmtew•tP•.la.ernnaS.nwo eoT n•o+w••rse wawnm.•e.rl <br /> L 81 Lk,ITT 51 WCCE Bus.Lic <br /> CONTRACTOR ( V\ <br /> X2100\ 1'J 1N- a�1d wA $D3� ' Phone2ma fYllW(1 'f NPR <br /> Address Z CONTACTFOR,� � 1QLT�I <br /> TENAN USINES N Qa V`�rl,= <br /> Phono/E-mall x <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK A InA <br /> HEAT SOURCE _ <br /> Existing Use of Building '— <br /> GH Electric Other <br /> Proposed Use of Building <br /> Building type, ).(--Single Family -__Duplek_Townhouse !Multi-Family gn_SpriCommenkler <br /> klecial Jy,mss <br /> T of to cl. Now Addhlon Ramotlol Ra a.r T.I. Sin Sprinkler Demohbon Chan a of Us 1I(J <br /> DESCRIPTION OF WORK faddrtmnsl SpOM pm,oded on The bscA) � <br /> `R�ntio��� (ZG �lQce �ab W01P-X HeO e-er un 2Jc <br /> (taGa.tl cnt. <br /> MECHANICAL PERMIT APPLICATION <br /> PLUMBING PERMIT Ara <br /> PPLICATION <br /> Typv or Prolecc _Naw_Mon _Altelollun_ncpa" Typnol Proled; ahrNDNumberd an of firturostlon_RaP¢Ir <br /> Show Number or fixtures Toilet <br /> NC–air handling units _ Bathtub <br /> ­77Forced air s stems —. Lavato wash basin <br /> Gas i iing Shower <br /> Water heater Kitchen Ink b dls sal <br /> Gas lira lace — Dishwasher <br /> Gas ten a Clothes Washer <br /> Clothes diver Water heater <br /> I Ran a hood Sink servicelbarlmo lett. <br /> Exhaust fan Backrim reverter <br /> lies tPurn Urinal <br /> Unit healer Drinking Fountain <br /> Boller Ffeet drain <br /> Said oration Grease Ira <br /> Woodstove Root drairsi <br /> Buclln Medical Gas <br /> Other. <br /> SPRINKLER ; SUPPRESSION SYSTEM Other: <br /> Number of Heads Other'. <br /> Icalon and annw die•ems lu be nue are rmed Mprmisbn•of low•and ordnance,gn•emna the type elver/.we be compsed <br /> I MnDY certyy that I nau•rted end naa qhu Mn 0 awwa,v cmcvpwovis_ <br /> wan rd olhe•petered horeln dr rot.The pnnlna M a perms does fid PnmmUe CK.fon b nud• I comply with 1�•Sbl Conpe Ipra law Is 27 RC W d J96 TOOA WAC <br /> IMI'am 6,g outed by Ne owner of Ihb pmporty to we"one wwra Im whkn app <br /> \_ =en —"pale (rowsod SW 12) <br /> ulhorlaed Agent Signature <br />