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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SrRVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 �wnv.everettv+a org <br /> S�—I�I — I <br /> SITEADDRESS: PHOaENN7Axa P t�iia ,l �1 <br /> 2�azo Ruc1� /l�� E�ceertW�1997A1 <br /> LEGAL tor nevi construction� Snan P�aVsubaivision Lul No _ (ailach copy ol lon9!egai eescnpPmQ <br /> OWNER � r,.}A� /.LhOI�Z .�. Phonc/E��na� �21 �- 5408 (�C��CI .101'1 <br /> Adaicss Cdy�5lateiDp <br /> APPLICANT. G�vrei OvmefsAgent Contractor �Coniraclor'sagent 7enanty-,�:i��:.:�.�w-crm:•��,-a«ommo..r��meo.o�•_ve,ro�� <br /> CONTRACTOR �U(IU '�i � S State Li:.#� ��� � Cdy[ius Lic N �l ✓ <br /> aam�s: —T�l � � IBuo I[� ��1�10 !�/ .0 % no��mY[r7-C�.� , , . D�►t <br /> TENANT BUSINESS NAME CONTACT FOR PERIUIT <br /> �IaMEs�•Nu�so�� <br /> f�EQr� Nc� P�o��,E.ma.� �,�,� �o _3�Lti � e �a <br /> BUILDING PERMIT APPLICATION CfiNTRACT PRICE OF WOR 1Q�000 _ <br /> Ex�sling U5e ol Bwldirg_�"����2 Sa l o�� HEP.T SOURCE. <br /> > n <br /> Proposed Use af Bmlaing 1-�CiTZ R�A��e�� �8Q �OC RZIo�-� / _ Gas _ Fiectnc__ O,ner._ <br /> BuJding type _Singi=_ Fam�iy _Ouplex fo�.vnhouse _��1ulti�Famdy _{CommCrdJl <br /> 7ype of pre�ect f7ec: Adtl�tion _fRemotlel ___Repa�r_T i _Sig�__Sonnpler_Cemeid�on__Ch�nne cf Use <br /> OESCRIPTIONOF WORK(atlC�rronais;acrpo�rCedonrneeac:l �ju.\e� OJT E�IrS��w� apTw�oM To mntE �f <br /> t1 D�4 C e�.f�l,�1- . AJE�swa-EtGL{I �_---t----`3--�wc� � • • - <br /> �011L{' /FNu u1A$h �}��-i �.� �nTll POOh . . . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _Nnw_Addn _Altcratlon_Repalr Typo ol Pro�ecL _ New_Addn _Mlcratlon_Repair <br /> Show NumOrr(aJ of IiaNres ShowNumbcr(MJ o!lirfures <br /> � i NC -a�r hand!ing units e� <br /> � Fora:d air syslems � Fiathluo <br /> � Gas p�pmg �ash ba5in) <br /> Water heatcr � ShoH�er <br /> Gas fireplace I Ndchen sink&disposal <br /> Gas nn9e � ishwashr.r <br /> I Clolh=s drycr � C hes�tiasher _ <br /> � �(2ingc hood ^ �W����h�7iler <br /> -� �-M- h ��T„��a� � Sink(sr �CclbarlmoNctt) <br /> � Ilcat p ip � [3ack0ow vc�ter <br /> j Und hcatc � Unnal <br /> I Uoilcr Drinkiny founta <br /> ; RefrlyeraGon � Floordrain <br /> � Woodstuve I Grease Irap � <br /> Ducting � Roaldrains <br /> Olhcr � htetlical Gas <br /> SPRINKLER I SUPPRESSION SYS M j Other <br /> � Other <br /> Numbcr of Heads I <br /> I�Crc�y certily IOdI l�ave fea!anE eWrtineU Ihis appLwlqn and know I�e s:me lo�e INe dna[orrM.AO pro�ision5 o/1aws.nd am:nance5 9ovem�ng I�u�ype olwmk m7 Ue co )ied <br /> Nr,�v.het�cr sDecdied�ciemor nct The;�antieg cl a C��A Eoes no�;�escme lo give a1.�onty lo noia!e oi wnael the F'omsicn of any cL1tt siale or local Imr�egulaL�g am�Y.n:Cion <br /> ThaI l am��Non:ce Ly inc oxnerof U'�s proD<M�a pertorm Nc uck for�+iuN appiicl;mn is maae ane I mmpry wan�ne 5ia'e ConVactwe lan IB 77 PCW anE 296IMA WAt ,I <br /> , <br /> � i <br /> OwnerlAulhorized AgenlSignature Dale (Hev�sed 1207J) <br />