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PERIVIIT APPLICATION <br /> BUILQING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <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 � ' b `� 3 <br /> 5�� � RESSt�' ,l _ . �lc' PROPERNTAX71 PERM13�Z�O � <br /> :�) v C" <br /> LEGAL lor new constructio�: Shon PlaVsubdivision Lat No._ �attach copy oi long legal desc�plion) <br /> OWNERK�I� �� �V `����"�� PhonelE.maiI�GL���C�L�•JI_L�� 1�.�-�Sll:,�ll�.��`� i� <br /> AEtlress G.. '� -- 1 � � City/SlatelZip �� l � � � � �I <br /> APPLICANT:�Owner OwneYsAgenl _Contractor _ConiractcfsAgent _Tenanll���+�ma�ae.e�rc�oim��e�.�>�r.�^nneowmm�uo+�) <br /> CONTRACTOR Y � v1 L 8 I Lia# COE Bus.Lic.# <br /> AdOress <br /> Phone:Email <br /> ENANT BUSINESS NA E CONTACT FOR PERMIT � <br /> _: �� (� t�t�'�v ���cl��f� ��u� c� ��- 4�'�C'— <br /> �(_`(�,��"�,� Phone/E�mail <br /> BUILDING PERMIT APPUCATION CONTRACT PRICE OF WORK - 1 �' ' ' <br /> Eaisting Usc of Bui!ding �-����-�r ` � ��•'� � t� ��« HEAT SDURCE: <br /> �����L �. <br /> Proposed Use o(Buildiny Gas EicCric Other <br /> Building type: _Single Family _Dcplex_Townhouse _Multi-Family�Commercial <br /> T pe o! ro'ecC New _Adtlition Remodel ' Repair T.I. Si n 5 rinkler Demolitpion Chan e of Use � <br /> DESCRIPTION OF WORK(adtlitional space provi0ed on tne�acki: �``�v ,(.{;����.; ��.�-I,u`�r� �G�t—i �lJ <br /> <<J=L1 P`�T ���i ����`����tv� f�e�.F <br /> MECHANICAL PERMIT APPLICATION PI.UMBING PERMIT APPLfCA710N <br /> 7ypeo/Project: _New_Addn _Alteration_Repalr TypaolPrqect: _New_Addn _Alteratlon_Repalr <br /> Show Number(M)ol fixiures Show Num6er(M)of ffr(ure. <br /> NC-air handling units Toilel <br /> Forced air syslems Balhtub <br /> Gas pipin Lavalo (wash basin) <br /> Water heater Shower <br /> Gas fueplace Kitchen sink&disposal <br /> Gas rang� Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(servicelbarlmop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlain <br /> Retrigrration � Floordrain <br /> Woodstove Grease trap <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads � Othec <br /> I hcrn�y cci�Ry Ihat I have mad antl ceambeE I�is applkallon ana Anmv t�^samc lo Ca Imo antl cortetl.A�I pmvisions ol lawf end orEmanwe Boveminp Ihif lype ol woh N+1 Ee wmp4ed <br /> wAh�Meu..f 5penfeE�erein o�nol.Tha Branling o�a pemmt Ooee nol pmsume lo grve auP�onty lo vioUle or can[el lho pmvisan ol eny ol�e�slele o�local bv reBu�ling cons:ivctien <br /> �N�Ocnaut�otlxeEbyl�oowncratlhiapropeM�oFeCormlhcrvo'.klorwlnc�aVCecatror.iema�candlmmply�vi�lhe5�alaContraaenLnwlB.]7RGW m029610JA1'7AC. <br /> ��\.A�l��.�J'`Y1 ����,�' <br /> OwnedAuthodzed Agent Slgnature Da�e (Fevised N207P) <br />