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425-252-1666 c.m.heating 14:13:51 10-16-2015 3/4 <br /> I=IMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/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 /> SITE ADDRESS: .51,), <br /> Gst t m 9gQ PROPERTY TAX ItERMI <br /> ` 06 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal ldeI description) <br /> OWNER INA 4-0 QL D Phone/E-mail L1 a9 <br /> Address 'c Rose voty City/State/Zip ek r-D uI t ,c f /\ ri <br /> q p n <br /> APPLICANT:_Owner Owners Agent V Contractor _Contractor's Agent Tenant(muststprovide a later mtt <br /> et the` g <br /> wnoerrtto do Work in the space) <br /> M •Y' 1 <br /> CONTRACTOR CI'1 i4a�I �n.0 State tic.# 7�al5oCity Bus.Lic.#O`10Ogg <br /> Address I4IS $rOCIC6C I li.ere1t1- r J A gg3or Phone/Email 259 Wal4, <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 125 25q(¢►olek. <br /> P ane/Email(�g iP. optivued'jhQ.cowl <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 17i'- a 1 <br /> Existing Use of Building HEAT SOURCE <br /> Proposed Use of Building Gas_ Electric Other_ <br /> Building type: Single Family _Duplex ._Townhouse _Multi-Family _Commercial <br /> Type of project: `New Addition _Remodel . Repair Ti ,Sigg Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 19e-PLPta <br /> &As P.W2 NA CC <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: _Now_Atkin JAltoration Repair Typo of Project: New`Addn Alteration Repair <br /> Show Number(#)of fixtures' Show Number(#)of fixtures <br /> 1 A/C-air handling units Toilet <br /> 1 Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> 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 /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler. Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Other: <br /> Number of Heads Other. <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.At provisions of laws and ordinances governing this type of work wit be comp) <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Lew 18.27 RCW and 296.200A WAC. <br /> 1,Q`\10�IS <br /> Owner othorized Agent gn tura ate (Revised 9/2014) <br />