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PEi�MIT APPLICATION <br /> BUILL�INGIIVIECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257•8857 Hnvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � a���`-� Z <br /> SITE ADDRESS: r PROPERT'TA%a IT� <br /> `����� l-U[�i1 'r'.l 'wl. Z.�D <.`ICC"ZOi; I[U � _ <br /> LEGAL lor new construction: Short PlaVsubtlivision Lot No._ (attach wpy oi lono legal description) � � <br /> OWNER V��� �`� ���t C� PhonelE�mail <br /> Atltlress ��j22 �.U;11� �j}- • .�� �UGi: CitylStale/Zip �q��(�S � �X � 520� <br /> APPLICANT: Owner Owner'sAgent �CoNractor ContractoYsi.gent Ten2nl(musto�oviaaeieneroiwnsen�kwnmeoxner�oao.wminmeswce� <br /> CONTRACTOR (�r-h �,':;4�n,- r�n�I �'cCI�i�r, L 8 I Lic.# CF I� C(U � C COE Bus.Lic.# <br /> Address T.(�. p>CIC JZOS �l�� Y��(�Y� i�L'�. l�'�l�'3 PhonelEmail ��Z7-'��- �z� 3 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Je�ca�y ���dtllrv. <br /> � � �I E'�/Cu1 Pnone�e�mau ��2.>-62i - 125 <br /> BUILDING PERMIT APPLICATION CON7RAC7 PRICE OF WORK S e��' <br /> Existing Use of Building ���4,� HF?.T SOURCE: _ <br /> Proposed Use of Builtling � ��•, 1 Gas_ Eiectnc__ Other_ <br /> Buitding lype: _Single Family _Duplex_ Townhouse _Multi-Family X Commercial <br /> T e of ro ecl: New Addilion Remodel Re air T.I. Si n Spiinkler Demolilion Chan e of Use <br /> DESCRIPTION OF WORK(add�Gona�space pmv�ded on the back): <br /> --�il�-Ici �� CW�li( �r'��Y(�/l U+C.�� �/1 CCcIPf Qv�G� I�Q11�J�/cY�7Lil ['�y��,I�Alai)�. <br /> MECHANICRL PERMIT APPLICATION PLUMBING PERMIT APPLiCATION <br /> TypeoFProject: �,New_Addn _Alleration_Repair TypeofProject: _New_Adtln _Allera�ion_Repair <br /> Shaw Namber(#)o/fixmres Show Numbei(#)ollixfures <br /> A/C-air hana:in units ! Toilet <br /> I Forced air s stems I Bathtub <br /> I Gas i in Lavato (wash basin) <br /> � Water heater I Shower <br /> I Gas fireplace I, Kitchen sink&disposal <br /> I Gas ran e i Uishwasher <br /> � Clothes d er I Clothes washer <br /> Ran e hood I Water healer <br /> i Exhaust fan I Sink(servicelbar/mop/etc.) <br /> I Heat um I Backflow rev�r:ier <br /> I Unit healer I Urinal <br /> Boiler I Drinkin Fountain <br /> I Refri eralion � Floordrein <br /> I Woodstove �I Gease tra <br /> I Ductin ; Roof drains <br /> � Other_ I Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM � Other: <br /> Number of Heads � Other <br /> I�erc�y cr.tlAy t�al I havn reaE aH eRamine0 i��is appbcal:on and::r.ow�he same to be Irue and rorzed.A:!provisione ol lavrs antl oNlnonces BoveminB Ihis typ:ol work will0e complieC <br /> ��In.mether specdmC�erein on The BranlinG al o permit does nol presume�0 7ive aul�onry lo violale o�cancel l�e provision aluny ulher stala or loral law repula�inB�ensbuction <br /> T�a11 em auNoizetl Oy the o�mer ol lhia prope�y to p^�arm l�c wark IorwliiG�epP�'��ion b mnEe anE I comply wi�n Ihe SWIe Contraclors Lnw 18.27 RCW anC 206200A WAC. <br /> ` .�tt�t, � ' ���: ClC �_- �2'L�'j '/Z <br /> OwnedAuthorj[ed gent Signature Date (Revised 62072) <br /> l <br />