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Feb- 19. 2016 3: 59PM EVERGREEN STATE HEAT & AC No. 6350 P. 1 <br /> IERMT APPUC AT00N- <br /> B GELDiNGI ECHANICALIPLUMBINGISI NISPRINKLERIDEMOLITION <br /> CITY OF EVr:RETT PERMIT SERViCES <br /> 3200 Cedar St., Everett,WA 98201 426,257-8810 FAX425-267-8857 www,everettwa.org <br /> 3ITF-A)7DRE8Ss PROPERTYIAH# :Ipm <br /> T <br /> LP-19AL for new construction: Short <br /> 'P`llal/sub6ivislo Lot No. (attach cofpiy of long legal descAptlon) <br /> OWNER ��✓ Phone/F;-Mall <br /> �25 <br /> Address 1. ✓� City/Stele/Zip r <br /> APPLICANT- Owner owner's Agent X Contractor Conlractors Agent —Tenant(meal prov[da alai teror consent from the owner to do work In the epaca) <br /> CONTRACTOR <br /> RACTORv City flus,Llo.#p 5 <br /> Ph�o e,Emall –�f 1�•G <br /> Address &411 Z. CONTACT FOR PERMIT <br /> T15MA T slNEsS NAME C w-1) fyf <br /> CNS 5L 0 <br /> Phone/1=mal[ <br /> BUILDING IPERN11►7 APPLIICATRON cONTRACl PRICi;OF WOR ; � <br /> Exlsting Use of Building HEA`FSOURCE: <br /> Proposed Use of Building Gas Electric other <br /> Building type: Single I amity •_,,,,Duplox ToWnhouse_Moltt-Family _Commercial <br /> Type ofproject; New Addition Remodel Re aft T.I. Sign S rinkler,_Demofition Change off Use <br /> D SSC RIPTION OF WORK(additional speoe provided on the back): , <br /> MECHANICAL P1�113f�IT APPLICA�T110H Fo LUM09HO PERMIT APPLUCATION <br /> Type of Project: _Nsvr_Addri ­Alteration_­Repair Type of Project. ,_New_,_Addn �Iteralion—Repair <br /> show Number(#)afflxfures show Number #)offixfores <br /> AIC–air handling units Tollet <br /> Forced airsyatems Bathtub <br /> Gas ip(n Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran a hood Water heater <br /> Exhaust fan Sink servicefbar/mop/etc. <br /> Heat urtlp idackflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Waodstove Grease tra <br /> Ducting Roof drains <br /> Other Medical©as <br /> SEDRI1�9>LER/SUPPRESSION SYS ITEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this appucatlon and kriowthe same(o ba true and correct.itis provisions orlawa and ordlnanoea governing this type orworic vhll be compiled <br /> wlih wh ether specillad herela or not,The granting or it p armu does not preaume Wgtva auIDority to vlown or cancel(ha provision or any other stela or local law ragutalrna construction <br /> Thal I nm author' ed the owner of t opt to perform the work rorwhlch appiosuon is made and i comply vMh the Slate contractors Law 18.27 RCW and 296.200A WAC. <br /> G�Revlsad 3/2013) <br /> Owner/Authorized Agent Signature gale <br />