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� � �-"'��� <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St , Fverett, 'JJA yE201 425-257-8510 FAX 425 257-8857 v�v✓�v evereP�.•:a orq <br /> SITE ADDRLSS: ��J Cu�bY /' Q PHOP[RTYIA%q PE Il n I� <br /> � <br /> LEGAL br r�,ev�ca-strirL-n �n;rt PlaUsubO vis�c'� Loi tio. (a�la[h¢py ol ieny�cyai dc.u�,•��,�� <br /> OVJNER �/1�� ���5 Ui(�G ( W«�rt.t ��� Phone�E mail �(7t- C-�Z"3 () T <br /> Aaeress 3�Ua C.��by �f C�I�.,SIa:e�ziP �!✓de�T, !�l �t �(i2cl <br /> A°PLICANT:KCwre� �'r,ne�3tgert Corbacicr CunlroUorsA3ert _7eraM!,...�:�r-.�earv,.e.c�:_-.,..ro-...��. -�.i ,., � .. <br /> a /� /J� <br /> CONTRACTOR V��,n�[r /�p /"�afa Statel.c # C�tyOus Lc # <br /> ��t: b! �YB f lu�i � Nn..,�;�Tea2o6 365�409v ��9e��� l�...l � [�ya.'� �� � <br /> TENANT 6U`S�INESSr NAM/E CONTACT FOR PERMIT / <br /> f�vQ/��l �ris�,,.liy �il..:t L2f'ZiZ'293�. �1.SChf.a��iQ�4�Pir�G�f�w-c��, �tn_ <br /> �'+o�e�E-ra.i t <br /> BUILOING PERMIT APPLICATION CONTRACT PRICE OF WORR <br /> Frist�ng Use eB���ltlmg .___ HFAT SOURCE� <br /> �'�000sed Use ol 6u�.'din3---- — Gas_ E�edrlc_ c�rer_ � <br /> f3wty�ng!ype. S;rg:e Fam,ly _Ddpiea_Townhous� _MuIt��Fam��iy _Ccmmerual <br /> i yDe cl Fro;ed Nevi AddAion Remodel Repart_T I _Sicn_Sor�nkier DemolAion Cnange oi Use <br /> — — — � <br /> DESCRIPTION OFWORKfadenoneispaceprov�eeeo�rr,eta:e) <br /> Rt�l��[ �mwv ��tie i,•s:�e l,6�:/�,•� .(1e�o.-�o� �v p,�c:J� Str.er <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> lyno ol Pro�ed: __New_Addn _Altcration_Repalr Type ol Pro�ect: _New_Atldn _Alteration_Repan <br /> Show Numbcr(a)o/firfures Show Numbrr(A)o/!ia lurcs <br /> A/C-a�r'�andi��r� ��d; Todcl <br /> I !'orceA au syst=ms f3athtub <br /> Gas p�pina lavatory(wash basin) <br /> Wacer heater Showcr <br /> Gas}ireplace K�tchen sink S tl�sposal <br /> � Gas range D�shwasher <br /> I Clo!hes dryer � Clolhes washer <br /> Rangc hood Water heater <br /> � Ckhausl'an S�nK (serncelbar;mopletc) <br /> HCat pUmp I E�ack!Io+v preventer <br /> Unn heater I Unnai <br /> I Aodcr DnnY,mg Founla�n <br /> I Refcgeration Ploor d�ain <br /> Wcodstove Grease Irap <br /> Ductriq Roo(drains <br /> � Other _— — � tdedlcal Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � other Sa4,� r;r•� �� /a�.nr.l <br /> � td��,rrGer er Hcads � Other. <br /> Ib!^CCyceC�'p�Pa:l':ave�ca�a'�Oeegmmetl���5ac:-�a'�o�an7Anpwl`esa�no:o0elrueaedeo:RCIPIIpmnS�nsollawspn0o�tlinanWsgOverninglh�.flypealxo�tv.��, .� .�e� � . <br /> �en:��.ne��e-speur,e7]ereln ai nol ihe qren�mp of a pennA Coee nol presune to grva amhorAy to vb!ate or rnncel itlo pmvlsan ol�ny cfher s�Ne m Ixei Ww regNeS�q c""-.'-.r� .-� <br /> 7ha�1 am awhor�:eC Cy M uncr ol�his prapenyle pMorm Ihe worAtot vAi-l�aDPl�cation is maEe aM 1 com0ry wd�t�a Sie1e ConlrOciore law 10 t7 RCW m0 2%7GJA�.'. . <br /> �(/J l�Z'+/iy <br />�, OwnerlAut ohzedAgenlSlqnature —"-- De�., �"^�-r_ -4:7+;� <br />