Laserfiche WebLink
Jan. 27. 2016 3: 30PM EVERGREEN STATE HEAT & AC No. 6178 P. 1 <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEM®LO o I®N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St:, rzverett, WA 98201 4.25-257-8810 FAX X425-257-8857 www.everettwa.org <br /> SITE ADDRESS: q n t--e�-�l. o V2`�� pROP>RNTAXJi P "In <br /> 1,6Q(_ <br /> LEGAL for new construction: short PlavauhndivisloLot No. (attach copy of long legal description) �) <br /> OWNE5R PrtonelE-mall Zi� �5R r �kCs� <br /> Address �j�-Q,�;l1rU /Z{C�� City/Stale/atp C�UC W�4 . K <br /> APPLICANT: Owner _„-,Owners Agent _Contractor _ConiraetorsAgeni —Tenant(must provldnaleuerorconsentfiomthewvncrtoaowork Inthe space) <br /> CONTRACTOR CU= - tJ & CJ E s 1 A& State Lic,#C, r,,6 0 City Bus,Liu.#0 <br /> (� hC on�e/�ma►5�-3 i <br /> t <br /> Address �l'2 r "C C <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Kcti S�L.o C tp:Vv <br /> Phone/E-mall <br /> BUILDING PIER-MIT APPLICATION CONTRACT PRICE OF WOR <br /> t=xisling Use of Building HEAT SOURCE' <br /> Proposed Use of Sullding Gas Elecirle y 011ier <br /> Building type: _Single Family _Duplex Townhouse Multi-Family —Commercial <br /> Type of pro eot: New—Addition —Remodel Repair TJ, Sign_Sprinkler Oemolltlon Change of Use <br /> DESCRIPTION OF WORK(eddil►lonaall s"pacep jvided oo the back): , <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypB of project: _,,,Neuj_Addn Alteration Repair -rype of Project: _New„_iddn Alteration_,Repale <br /> Show Number(#)otAxturas show Number(#)ofilkiures <br /> A/C-air handling units Tollet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin <br /> Water heater Shower <br /> Gas fine lace Kitchen sink&dis osal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink se (Ice/bar/mop/etc. <br /> Heat pump Backflow reventer <br /> Unit heater urinal <br /> Boller Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease tra <br /> Ducting J Roof drains <br /> Olher Medical Gas <br /> SPRINKLER/SUPPIRli:S,SION SYSTEM Other: � <br /> Number of Heads Other: <br /> 1 hereby certify that I have rep@ and sxamined[his applloauon and know the same to be true and correct,AO provistons oriaws and ordinances governing]this type ofwork wrl!be Complied <br /> with whether speoWed herein or nol,The granlin of a permit does not prosume taglve aulhorityio violate orcancel the provision of any other stale or 10041 law regulating construction <br /> Thnt I am authorize by a ovmer of this pr� Io perrortrt the woik Tor which oppoesuon is rrade and I comply with tho Slale Conlractors Law 18.27 RCW en4 298.200A WAC, <br /> AJ <br /> owner/Authorized Agent:Signature Date (Revlsed 312093) <br />