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� • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNlSPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT �ERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evereriwa.org <br /> /D —O$'1�{ <br /> SITE ADDRESS:� PROPERTY TAIf p PER T�1 <br /> / d �cv fi � D�-033 <br /> LEGAL for new conslruction: ShaA P�aVsubdivision lot No._ (atlach copy ol long Iegai description) <br /> OWNER `�u SG�k K� �' Phone/E-mail S � � � <br /> Address City/Slate2ip �(i,�,/�7'/- � <br /> APPLICANT: Ownet _OwncYsAgen� Coniraclor �ConlractoYsAgent TC�BOI�muttpro�ieealcllerohonfeMlram�MmmerlaMwah4amospace� <br /> CONTRACTOR / Slate Lic. # G �g� ify Bus. Lic.il i�3 C! <br /> Adtlress Phone/Email ' <br /> TENANT BUSINESS NAME CON7ACT FOR PERMIT <br /> P�onc/E-mail "" � —' <br /> BUILD.NG PERMIT APPLICATION CONTRACT PRICE OF WORK ��� � <br /> Existing Use af Building � �� HEAT SOURCE: <br /> Proposed Use of Building Gas_ Eledric_ Olher__ <br /> Building lype: _Single Family _Duplex_Townhouse _Multi-Family�Commercial <br /> Type ol projecL _ New _Addilion _ Remodel _Repair_T.1. _Sign_Sprinkler.__Demolition __Change ol Use <br /> DESCRIPTION OF WORK(addmonal space prowdetl on me back). <br /> �QC/k�l�C m/!9 5�.,<< �mSt �.� �Z'.��.rx � ��.� %,�r5r.��� ?��✓ S�ow�� �4� <br /> �� 5�����a� • /��.n��� k,.y RG��(iCL fi�Y� �� h�" o.� ti". t�,�u ���,s <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofPfoject: _New_Addn _Alteration_Repair TypcolProjec�: _New_Addn _Alleratio Repair <br /> Show Numbe�(p)o/IixNres Show Numbrr(a)ol fi.turcs <br /> AIC-air handling units I Toilet , <br /> � Farced air syslems � Bathtub <br /> � Gas piping Lavatory(wash basin) <br /> � Watef healer � Shower <br /> � Gas freplace Kdchen sink&disposal <br /> � Gas range Dishwasher <br /> � Glolhes dryei � Clothes washer <br /> � Range hood � Waler heatcr <br /> [xhaust fan Sink(service/bar/mop/elc) <br /> lieatpump � Backflnwprevenler <br /> � Unit heater � Urinal <br /> �8-oder Drinkin9 Fountain <br /> � Re6igeralion � Floordrain <br /> � Woodslove Grease trap <br /> Ducling Roof drains <br /> Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � other: <br /> Numher of Hcads � Olher <br /> I nereby cetl�ly I�al I�avo iead an0 e.amined IOis aDPlmxlion nn0 knowlhe same lo Ce Ime and correcl.A!I piovisions ol laws antl oidma�ces gaveming Ihls lype ol waik wi1 be�mmphed <br /> wilh w�e��cr spe<ifed hereinar nol T�e q�anen9 of a permJ EoeS nol Oresnme la give avl�w�iy to vialale oi cancel i�e povision 01 any olAv ilale or local law¢gulalirq conilmcliai <br /> T�al l am nat�oritetl Cy�he owne�ol i�is p�operlY lo pedorm Ihe wod for wA�ah appiicalion ii made and I complY w��h Ihe S�aie CoNrapais Law Itl i7?CW and 39E 200A WAC. 1 / <br /> ��Z <br /> 1 <br /> /� �o ` 2� ���--� U �( (�l.�Il.� <br /> O�rlAulhori:edAgenlS nature Dale (Ro�ised9Rc'1J) <br />