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425-252-1666 c.m.heating 08:13:40 10-02-2015 5/6 <br /> PERMIT 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.or <br /> SITE ADDRESS: PROPERTY TAX tt PEg(yl #� �J <br /> -�� VST -e--U-e(2--Cd �S__ IYAVI <br /> LEGAL for now construction: Short Platlsubbdivislon Lot No. (attach copy of long legal description) <br /> OWNER c`'t NPtG R Pt Phone/E-mail -t -3\`J - (0 g <br /> Address Co 33 p ,DV, City/State/Zip <br /> APPLICANT: Owner _Owner's Agent Contractor Contractor's Agent Tenant(must provide iot:or or``consent nem the owner in On work in the specs) <br /> Qin m Het NG State Lic.4 CVO-e� Q` <br /> s OciSccity Bus.Lic.# 0I6actS <br /> Address \,LA\ ( onQJvf\t I _ 1 Phone/EmaiL1,p5-dA 0S-9) Citi fl n3,com <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> OeBaeCIAMVLe_t Ct r «m _ <br /> Phone/E-mail "1 -s aa� S`�- O Q <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 11 5053 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas ElectricOther <br /> Building type: Single Family _Duplex Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sign Sprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> R120q eQ ¶3 S -cus(2--naC <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: _New_Addn _Alteration_Repair Type of Project: Now_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units Toilet <br /> 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 /> Boller Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other_ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby codify that I have road and examined this application end know the same to bo true and correct.All provisions of laws and ordinances governing this type of work will bo 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 Law 18.27 RCW end 2e0.200A WAC. <br /> 47.-LU 9A0(5 <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />