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PERMIT APPLICATION <br /> BUILDING/MECHAMICALIt�LUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Evere�t, WA 98201 - 425-257-8810— FAX 425-257-8857 —�wnv.ever�i a�a-va5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SIT[ADDRESS: PROPERTY TA%p PERMIT M <br /> 3$Ib 5,�„—H A�%E . OoS (�_ozS00003 ^$�S" <br /> LEGAL for new consimction� Shon PlaVsubdivrsion Lot IJa_ ailac copy of long!egal description) <br /> OWNER l"fr. ��,. � ES Pnone;6mai1 yz5•23Z•Sou� �STC!"�P�831��' \% �'+ <br /> Pddress .(/. 130K �S9 <br /> Gty/SIaIelZip v !'e ^A d <br /> CONTRACTOR No�� � SE���ce '�..I; L81Lic.# �/a iDL52I�U �7. <br /> w.+. o�^ • <br /> Address ��t� n M1D ✓nLE �✓� /{�. V s�.a11LF_ l-�� �1�/� �'honelEmail Zp(o. S2Z.q5 D � � r✓��L .[pM <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT M i�n A E�- �P• fM/T�! <br /> �n c,Fic. EN6 �NCctn..�� T£cN NO�oG��S <br /> S�U��-GNu�sL Pnone�E�man ZDk• P-"� •�Suo m�d-.ae, a Au e,l�, <br /> BUILDING PERMIT APPLICATIDN CONTRACT PRICE OF WORK '��Z.5� OOo �+ <br /> Ezisting Use of E3widing_ 5 "[D^,'a�+� `-'�� _ HEAT SOURCE�. <br /> ProposedUseofBuilding STDn+'ti4� S" � f Gas_ Elednc x Other _ <br /> Building type: _Single Family _Duplez_Townhouse _Multi-Pamily Lv,ommercial <br /> Type of projecC. _New _Addltion _Remode; 1CRepair�,T.I._Sign_Sprinkler_Demoliiion_Change of Use <br /> DescriptionofWork(additionalspaceprovidedontheback): T+��.f i��l..aA"�e.n� re�°�-:'l �° Vn�l'� � `E"�D 3ro ���� <br /> ' � Ne:lto•-CIFD�.7E PvdllT�A4C J.✓LI�VDInJL i..�TF�l.:Z ��..lI�NES � PLATFOr1.�+t � /N)ua-AY.N <br /> � TL. SPtLIl=��A77J'+J �02. I N"6.trE.�e.S � T�E DG'i�aTio.. SYfIl/"� NEoH.4ri�R� ALSD � <br /> Havcyoustartedworkingwithoutapermil? _YES �NO )KDicqi O D�✓ D/u1 �J��✓GS. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERINIT APPLICATION <br /> Type of ProJucl: _New_Adtln _Alterallon Repalr /� Type ot ProJoct: _Now_�ddn _Alteration_Repair <br /> ShowNum6er(N)oIlixtures SE�h �E Sh�.. 11umbcr(#1ollixtures <br /> A1C-air handling units I Todet <br /> forced ar s stems Ba�htub <br /> Gas piping Lavalory(�vash basin) <br /> Waler heater I Shower <br /> Gas frepiace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> ' Clothes dryer Clo�hes washer <br /> Range hootl Water heater <br /> Exhaust fan Sinh(servicelba��moplelcJ <br /> � Heat pump �ackflow preventer <br /> Unit heater Urinal <br /> 8oiler Drinking Fountain <br /> Refrigeration Floor dra�n <br /> Woods�ove Greasa Irap <br /> Ducting Roof drains <br /> Other �dedical Gas <br /> SPRINKILBR I SUPPRESSION SYSTEM Othec <br /> Number of Heads Other <br /> ^ereby certdy�hal l have read and examin.d Ihis app��cation and Y,n�w Ihe same to Ua fine and wrrect.All provisions ol laws and ordinances governing <br /> ,type of�•mrk will be complied wA�whe�he•specilie'hercin or nol.The granling ol a permit does noi presume to give authority to violate or cancel <br /> ine piov��,on ol ony olher state o�local 12w regulatin�wnstmction or Ihe paAormance ol construction.lhat I am aulhorized by�he owner ol this property / <br /> tu peilci i'i Ihe woB for,vh¢h p lion is made and I comply with Ihe Sla�e Coniractors Law 18 27 RCW and:96 200 WAC I <br /> ; ��� � 3 <br /> -�,.- l-z 3 �� Z � <br /> , �i,�`�,��' � <br /> G' � /1 r �eeviseu . � <br /> OwnedAuthorized Ag'ent Slgnaluro Date <br />