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� <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � /D ��Z <br /> SITE ADDRESS: PROPERN TAX p P R IT 1t <br /> 7601 R�r� e� 6 oc�o �too —(� <br /> LEGAL lor new constmction�. Shoh PlaVsubdivision_��/�' Loi�o._ (atlach capy ol lonq logal desulplion) <br /> OWNER L �pf PhonelE•mail y� � 334. 60s � <br /> naaress 3 SIS of�M M k� 1 c�iy�s�ni�rz�P � S US W k <br /> APPLICANT: Ovmmx_OwnersAgrtm Contracior CoNnctor'sAgent _Tr.nant�m:�siM�.u•,µr�o«*�+��nrn^me��.,�»�muowY�.�n��u.,�•i <br /> CONTRACTOR W r L 8 I Lic.# COE Bus.Lic.# <br /> r� r1f(r1R SS IkuO PhonelEmail <br /> AdAress � � s� �r s c: e� -r�o 0 o a s. � 3. s y s <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT GE�a9� P�EI��� <br /> ��d'� �1lU+��I� r PhonelE-m�+il �.L�� S�3. I�ly� <br /> BUILDING PER IT APPLICATION CONTRAC7 PRICE OF woRK ,� 39�c00 <br /> Existin9 Use of Building �l_o .�rd��t��� HEAT SOURCF: <br /> Proposed Use ol Building A�� . I�)."q_ a G Gas__ Eiectnc_ Other__ <br /> Building type: _Single Famity _Duplex_Townhouse _Multi-family _Commercial <br /> T pe ol pro'ect: New Addi�ion Remodel Repair T.I. Sign Sprinkler Demolilion Chan e of Use <br /> DESCRIPTION OF WaRK(additional spar.oprovidnAon N�o 6ack): Rt��CKlt�� `�KiSFi�+� {FTy�r l�•t{"C�+^�j hc <br /> A RtO�Acr..,twt" Q'JR J����� r� P.`Ic. �,�� A Ilr_v C�1�..••cY i•, 7�C dK���ia� .�tl,p�•.�� <br /> /�I�Dv�. 11VNI�S f��.SL��p��1L <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol ProJect: _New_Addn _Alterallon_Repalt Type of Pro�ecl: _New_Addn _Alteration_Repalr <br /> Show Num6cr(R)o!flYfuros Show Numbor(p)o/fiuturos <br /> {JC—airtiandlin units Toilel _ <br /> Forced a�r syslems Bathtub <br /> Gas pi in Lavalo (wash basin) <br /> W ater heater Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas ran e Dishwasher <br /> Clolhes d er Clolhes washer <br /> Range hood Wate�heater <br /> Exhaust fan Sink(servicelbadmop�elc.) <br /> Heal pump Backllow reventer <br /> Unil healer lJnnal <br /> Boiler Drinkinq Fountain <br /> Relri eration Floor drain <br /> Woodstove ' Greaseira <br /> Duclin ' Roof drains <br /> Olher ' Aledical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM ' O�her. <br /> Number of Heads O�her: <br /> I nereby ceNAy Iha�I nave reaa and eeamned thrs apP��-���un an0 know lhe snme lo b_We and conect.NI provisrons of laws and ordnarces goveming Ihis rype ol wwk wdl be mmpliea <br /> w,•,��wbelMr speafred herem w not.Thn granting uI n(mrtni�tlacs nnl presumc lo prve aumwny lu vx�4im w cancd lhe pmvrsron ol any oNer stnte or bral Ixx regulating mnstmctan <br /> l nal l am aul�onzed hy Ihe owne�oi N'�s pmperly lo pedom�Ihe wvM br��h¢h appikalron is niade anC 1 rort�ply w��h Oi�Slatc Cuntracto�Law 18.P7 RL1Y and 296.POOA WAC./ <br /> �� _ , ' Z <br /> �'__— <br /> �� � .� �_�'� ," ' 7�16���. <br /> Qwn�riAulhorimA Aqrnl Sig :llure � �.+la (Hf;v�sed 6'701?I <br />