Laserfiche WebLink
425-252-1666 CM HEATING 1f1.24:29 a.m. 07-28-2015 3/4 <br /> I'MIT 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: _ PROPERTYTAX k ii P IT <br /> FSq 1'S . 1pi't^ Dr St 0OI.310000. 022c0 I I i h1 <br /> LEGA!.for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER La(( l l to ru(,IG✓ Phone/E-mail y25 923 SSbt <br /> Address 81)3 i� r sE City/Stale/Zip EvQ-re '1' 'A,A q OZO? <br /> APPLICANT;_Owner _Owners Agent Z,Contractor _Conlractot's Agent Tenant(must provide a letter of consent from the ownerla doWO*tnthe space) <br /> MM ''11,,,, <br /> CONTRACTOR <br /> Clel'1461+l tn,L • 'State Lic.# l [ 4016134' City Bus.Lic.#Otto CMS <br /> Address,PhoneEnal5 'U^W�I` 63ou�dExWqg?o ti-Z '^ <br /> TENANT BUSINESS NAME CONTACTf09 PERMIT <br /> _l <br /> ho dtslr7b e N/I�lP4T1 <br /> . P one%E mal ..., ,C1)04 <br /> • BUILDING PERMI <br /> T APPLICATION • . cONTtzAcT PRICE of WORK., .11. t <br /> Existing Use of Building..:. HEAT.SOURCE: <br /> Proposed,rise of BytIding Gas_ FJectric, Other <br /> Building type: �/ Single Family Duplex Townhouse Multi-Family _Comniercial <br /> T .e of.ro ect: •New Addition . Remodel, :•Fie air. T.I. Si.n S•rinkier Demolition. Chan•e of Use <br /> DESCRIPTION OF WORK(add(additional _ • a <br /> dUronel space gravidae on the back): <br /> 1nSfall .Oakin hos.+- pump S35ttrr► <br /> MECHANICAL PERMIT APPLICATION • • PLUMBING PERMIT APPLICATION` <br /> Type of Project _Now_Addn :Ateratton Repair Typo of Project New_Addn _Alteration_Repair <br /> • <br /> ShowNrimber(//)ofBxturas' Show Number(#)of fixtures <br /> ::;A/C.=:"air handling units ' Toilet' <br /> 'Forced air systems <br /> 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 l SUPPRESSION SYSTEM other. <br /> 1 Number bf Heads Other. <br /> I hereby certify that I have read and ekarntned this application and know the same to be true and coned.M provteions 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 pf any other state or local law regulating construction <br /> That I am authorized by the owner or this property to perform the work for which oppgcaUon Is made and I comply with the State Contractors Lpw 19.27 RCW and 291200A WAC. <br /> • 4.24-)5 <br /> Owner inhoriioa"Agent gesture Date (Revised 9/2014) <br />