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� , 1 • • <br /> � " PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> • CITY OF EVERETT PERMIT SERVICES <br /> 32C0 Cedar St , Everett, WA 98201 425-257-8810 FAX 425-757-8857 w�wr.everetrNa org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: VROrEnTr tAz u R a <br /> I I rt' PIG vE . 00 990�I201500 I`�JD -OS <br /> LEGAL!w rew mn�WCic� Shon PlaVseCC�v�sicn Lct No_ (attaU Gooy o!Icr.g legal Cescrp;ioo) <br /> OWNER �R J � 1 S E Pnonei6ma'i <br /> aaa��s D r�x 7 c�nrs�����o SAN RA A �f !J <br /> APPLICANT: _Owner OwrersAgert xCon;xc• ContraCCYSAgent 7enant����.�v:-•-��•��-e�o��+ri+cR.�xo..�o.•oeo.c+ �n.,w�� <br /> CONTRACTOR Q` !� L �-`�CN/+J�I1�i�L�-/`rC� LBILic tt OLYMPMII7 OI COE �us Lic. � <br /> ACCress Z\���' 6�p� A w � 51�1� � I�1� PnonelEmai'� �{Z5'77�I�8� <br /> TENANT BUSINESS NAME C NTACT FOR PERMIT <br /> SHERv,liN W�WA�s ' o�� olyMp�cx.ec..L.a�;«..l ,c,,,�,� <br /> phone�6rra�.l 'J <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �'fZ.QO <br /> Exisling Use ol Bw!d�ng� FAIN �__��, HEAT SOURCE. <br /> ProFosed Use of�uilding Gas_� Eiecn:c_ Oiner_ <br /> BmlCing type. _Sinyie Family _Duplex_Townhouse _A'ulti-Famtly �Commcraal <br /> Type ot pro ect New Aatldion Remodel Re atr___T I. __ Sign,__Spnnkler Demohtion_Change ol Use <br /> OESCRIPTION OF WORK(aeainonai space pmv�actl on mc bace) <br /> �.��c�� �- 1�P�r� Rcr�=zcpNic�n'r�j Hrc.�Ac�N�r' . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Pro�ecC _New_Atldn _Alleratimi _Repalr Type af Prqecl: _New_Atltln _Alteration_Repair <br /> Show NumEcr(tt)o/fi+tures Show Num�cr�o)o//i�iwes <br /> A/C-air handling unds ToJet <br /> - Forcetl av s stems �athtub <br /> Gas ypinq Lavaro (wash basm) <br /> Water heater Shower <br /> Gas fireplace Kdchen sink 3 tl;s osal <br /> , Gas ran0e U�shwashc� <br /> I Clothes 4 er Clothes washer <br /> � Ranye hood Water heater <br /> [snausl lan SmN Serncelbarlm0 letc 1 <br /> Ncat pump O:�ckllow prevente� <br /> UrA heate� Unnal <br /> �oder Unnkin Fountam <br /> Relri e�ation Floor tlrein <br /> Wcotlstove Grease trap <br /> Ducun Roo(tlrams <br /> Other �dedical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM otner <br /> Numher of Heads Other <br /> I no�eby cerl!y I�al l�avn mad and e�amineG Nrs appLfalqn Jnp know IM10 s�me to bC W e an0�nrteO AI�pmvivons of laws an0 oNiwnces ga�eming Nis lype af woik w 1 Uo mmpReO <br /> wnn wnelner sDec`cC ncecm or nat ihe goN�ng at a perm�t does nol pmsume lo gne aul�omy to vu�iale ar pnul Ne pronsian^�anv ol�cr stale or iorJ�Ww regWa4ng mnswwon <br /> ��at I am auhorlxeE Cy roe owner ol Nls pmperry to perlort�Me work tor w�rcfi appl�caVon is maEe and I compp w�I�e State Cant2ctors Law�B 27 ftCW an0 29B 200A WAC <br /> � �-��-i3 <br /> wn uthorizc0 Agent Signature Date (Revisetl 6?Ott) <br /> �I� <br />