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Dec. 10. 2015 3: 56PM EVERGREEN STATE HEAT & AC No. 5856 P. 1 <br /> ERMOT AppucArior <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITI®N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425257-8857 www.everettwa.org <br /> B- r Lbor Pillr-• �� PROPERTYTAXfj P� IT'# 121ti. _ 1 1 f <br /> LEi1AL for new construction: Short Pial/subdivislon_ ,Lot No. (attach copy of long feel description) <br /> OWNER = Uge�t1a Phone/E-mall (WS/ Z -`'-- ,�5 <br /> C.t_ City/State/Zip `J✓ :lig LL4 al. 13 ZO <br /> Address i% �_ _ — <br /> APPLICANT:_Owner _Owner'sAggent _Contractor Contractor's Agent _Tenant(musgprovide ateuarorccnsenlfrom'ha owner todowodcInSoapace) <br /> CONTRACTOR G.). Q6g—to A-1-tom HeArA /V._ State Lie.#L. • iz.6. :'O sr Cit Bus.LIc.#0°- <br /> 252–3 11.-G <br /> Address 2..l SO A _ .QC, 'hone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT • • <br /> Kati SAL.o (if"z1) r6-2-":3P1 <br /> Phone/E-mail _1.i , , 0 I._ - I / - -_ <br /> BUILDING PERMIT APPLICATION — CONTRACT PRICE OF WORK ' 2r W <br /> -- <br /> Existing Use of Building HEAT SOURCE: • <br /> Proposed Use of Building - _ Cask Electric Other_ . <br /> Building type: k[ .Single Family Duplex Townhouse Multi-Family Commercial <br /> Type of project: —New _Addition —Remodel. Repair T.I.—Sign Sprinkler Demolition Change of Use <br /> DESCRiPTCON OF WORK(additional space provided on the back): , <br /> 64.1-4.XIL. 0C--T 64< 1--wtzi-�s.c <br /> • <br /> IVIECIIANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type or Project: New Addn _Alteration_Repair Type of project; _New,_,Addn _Alteration^Repair <br /> Show Number((l)of fixtures Show Number(#)of?Wares <br /> A/C--alr handling units I Toilet <br /> Forced air systems Bathtub ' <br /> 1111111 <br /> Gas .Ling Lavatory(wash basin) <br /> Water heater • Shower <br /> Gas(Ire•lace i<itchen sink&disposal <br /> Gas ran.e Dishwasher <br /> I Clothes dryer • Clothes washer <br /> Range hood Water heater <br /> Exhaust fan_ • Sink(service/bar/mop/eta) <br /> Heat pump BacIflow'reventer • <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain • <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> 1 Other _ Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads _ Other: - <br /> I hereby wiry that i have read and examined this apptIcsUon and know the same to be lice and correct.Al provisions of laws and ordinances governing Oda typo of work Wilk'be compiled <br /> with whether apecittect herein or not.Theranlin gpermit does not presume to give authority to Yolale or cancel the provision of any other state or local law regulating construction <br /> That I em authorized by I a owner of this riy to eon the work l'orwhleh application la made and I comply with the State Contractors Law 18.27 RCW and 29&200A W�A,C. <br /> L 'l.--- 44 / 4,0.4,c----- 42v ,'9 ; <br /> Owner/Authorized Agent Signature Date (Revised 3/2093) <br />