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425-252-1666 c.m.heating 11:30:01 11-27-2015 2/8 <br /> BUILDING/MECHANICAL/F=• MBING/SIGN/SPRINKLER MOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> I DDRES5, ' (.0„(1, (PROPERTY TAX# 1 Piattg I_6_44 1 <br /> L fir newconstruaion. Short FlasaJbdirision Lot Ho. (artash copy of long legal description) <br /> :RJQa 1 e [-Lti t iyi8 S Phone,..mail 14 q. -_ co4-(4,s0 <br /> 1(2trt Room-a-- _ =ily/State zipq ve.g L1 J Rol <br /> 7,ANT:_O:•.ner _Oemer's Agent V Contra:tor _Contra:toes Agent Tenant/rust F13eA3 3:es3rst=mart rr_r tri 31,rer to 17.c<r re ra:a. <br /> ACTOR DI 'O. ' T / 4 ''II-- city Bus.Lit:. #011D on <br /> C State Lir, -t+ �I�T <br /> • <br /> 1-MP-M 6roaclu901 6k re,ii- W P' q g2oi Phone/Email 425 2SCILoLola to <br /> IT BUSINESS NAME CONTACT FOR PERMIT <br /> p i,e, 1+25 2561 t20100,_. <br /> Pnane/E-maltitl ie.e OWtivlta .tow\ <br /> DING PERMIT APPLICATION CONTRACT PRICE OF WORK, (VS 4-S- <br /> Use of Building HEAT SOURCE: <br /> Id Use of Building Gas Electric Other__ <br /> type: Single Family _Duplex Townhouse _Multi-Family ,Commercial <br /> •rdect: New Addition Remodel Re•air T.l. Si n Sprinkler Demolition Chanoe of Use <br /> OPTION OF WORK(additional spacepro:fdedon the bask): <br /> In5teult d!uaL SS kfume, (►�5- ? -e1 C lD -lank <br /> 7ECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 'reject: _New Addn Alteration_Repair Type of Project: Now_-Addn _Alteration_Repair <br /> Show Number(tit of fixtures Show Number(#)of fixtures <br /> NC—air handling units _ I Toilet <br /> Forced air systems I Bathtub _ <br /> I Gas piping I Lavatory(wash basin) 1 <br /> 1 I Water heater I Shower <br /> I Gas fireplace I Kitchen sink&disposal <br /> Gas range . ( Dishwasher <br /> Clothes d er Clothes washer <br /> Range hood Water heater <br /> Exhaust fan <br /> I Sink(service/bar/mop/etc.) <br /> I Heat um Backflow preventer <br /> Unit heater I Urinal <br /> 1 Boiler I Drinking Fountain <br /> I Refrigeration Floor drain <br /> I Woodstove Grease tra <br /> Ductin• Roof drains <br /> Other Medical Gas <br /> PRINKLER/ SUPPRESSION SYSTEM I Other. <br /> Number of Heads Other. <br /> my that I have read and examined this application and know the some to be true and caned.All provisions of lays and ordinances governing this type of work MI be comp: <br /> en specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other slate or local law regulating constriction <br /> vJthoriiz�zedby���the owner of ads property to perform the work for which application Is made and I comply with the State Contractors Law 18 27 ROW and 298.200A WAC. <br /> �t Q,v./ ( 1 IX <br /> uthorized Agent gnature Cate (Revised 92014) <br />