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05/07/2015 THU 12: 55 FAX Fast water Heater U002/003 <br /> 0 0 SD 2r <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SI., Everett, WA 95201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> q� APPLICATIONS ARE ACCEPTED FRO/M/Ax�8 AM TO 4 PM <br /> SITE ADDRESS: I _I I a tow\bAr t.. --) PROPERTYgwcio 1(/D PERMIT Cr,l - <br /> LEGAL 'or new construction: Short PlaUsubdivislon Lol No (attach copy of long legal deacripllon) <br /> OWNER A, 1 , 1 PhonOfE-mall ,---h.1, .,- 1 l.{ "r , f� <br /> Adureco 1�1 u� ItAM1OolTylN Clty/State/Zip ��Q- F t� I vV ' <br /> - <br /> APPLICANT: Owner _Owner's Agent K Contractor _Contractor's Agent Tenant(most Favor,.moor or eoneenl 110th In.owner to do work In Ilia.peal <br /> CONTRACTOR fas-\-- \N& 77--\\--C'-c L&I LIc, #}- S-WN''C--99 SBC COE Bub. LiC # C)--Lj <br /> Address 115 Nortel Creek'Parkway South, Si EC-106 Bothell, WA 98011 :mall- S ��-�r;. <br /> 6 ib C g� ,��P«- _(,( <br /> 1�EN N TIB 171STN�E� NAMECONTATACT FOR PERMIT (44;p1 <br /> l ►Sr� S, iPhone/E-mair , ,, <br /> 0 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF ORK <br /> Existing Use of Building ILA 41ik 14 A a <br /> SEAT SOURCE: <br /> Proposed Useof 8ylld � Gas Electric Other <br /> Building type: SingleL/ Family Duplex Townhouse Multi-Family Commercial <br /> Type ofproiect: _New Addition Remodel Repair T.I. Sign SprinklerDemolltion Change of Use <br /> DESCRIPTION OF WORK(additional space provided on The back): qq <br /> . _ . e)...‘e,..-Q Q0._ J <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Adan Alteration Repair Type of Project: New Adan Alteration_Repair <br /> Show Number(,)Of fixtures Show Number(NJ of fixtures <br /> A/C—air handling units Toilet <br /> I Forced air systems _ Bathtub <br /> Gaspiping Lavatory(wash basin) <br /> 1 Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc) _ <br /> Hest pumpBackflow prevents( <br /> Unit heater Urinal <br /> Boiler _ Drinking Fountain <br /> Refrigeration <br /> Floor drain <br /> Woodstove I Grease Ira• <br /> Ducting Roof drains <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM <br /> Other: <br /> Number of Heads Other: <br /> I hereby certify that I have reed and examined aria epplicelon end know the erMr lo be true and correct.All provleione of lews end ordinance:governing l hie type of work will be compllcd <br /> wVth whelbor apecllled herein or not.The granting of a permit dose rot presume to give authority to violate or cancel the prov,sion of any other atom or local law regulating conslruclton <br /> That I em eulhodzed by the owner or lhla orooehv to oeriomt the work for which application la made and I comply wilh the Stele Contractors Law 10.27 RCW and 296.2005 WAC, <br /> , ,( OSI1�? <br /> �r /Authorizeo Aye ,-,,v,...,u Y � <br /> (Revise('6/2012) <br />