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Jan, 22. 2016 8: 01AM . EVERGREEN STATE HEAT & AC No, 6149 • P. 1 <br /> • <br /> p51 '.KT APPUUCA,T N <br /> BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLgR/DE OLITION <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> 3200•Cedar St., Everett., WA 08201 425-257-8810 FAX 425-25743857 www,everettwa.org <br /> sag ADD RiESS: PROPERTYTAX ft P iMMlT, <br /> LEGAL for new construction; Short Pla1/subdivlslon Lot No. (attach copy of long legal description) <br /> ___ _ . _. • milimimil,_. <br /> APPLICANT: . Owner Owner'sAgent __LGo tractor —ContraeloreAgentTenant mualprovide nrailer deeruentfrom MAeowoerledpwork InIna ewe) <br /> CONTRAOToR ecifwa(2C1 b4 (?UM ._ State L-lo.#� V,vet2�s 4Z2 l ` City pus.Lie.# Oo 11$— • <br /> rAddress 24 'C-['L[ k)6, e.UPPixt w4 6102-0 t Phone/Etna!! Z.S.- Zc2�1 I 1 • _ <br /> TENANT RIJ;;1NESS NAME " " l CONTACT FQ- PERM' <br /> Mot&60/no/A,e 1`� <br /> rI) r i`n't`jrCg 14O r Phone/E-mail 7`L•,'Ti fGY - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 700 <br /> • <br /> Existing Use of Building .6I �. 8 HEAT SOURCE; • - <br /> Proposed Use of Building /V 0 �- I4.P2I, ea a. Etectdo_ Other <br /> Building type: Single Famlly Duplex Townhouse Mult]-Family ..Commercial ' <br /> I ■e of project: New_Addition Remodel Re■air_T.I._Sign 5.1-inkier_Demolition Ct,i9gle of Use <br /> DESCRIPTION OF WORK(additional space provided on the beds): <br /> U. I Ajp/1610 Pan410 X 645 - rilP~ W/ PA) 17✓l/ox -- Sri 91411 41144 <br /> 1-0e0-600Act aviPmi.vf is bo(P'` 2 IV° C41"65 r'' C)°5146 Du q Mot <br /> - - MECHANICAL PERMIfAPPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: New_Addn _Alteration,,,._,Repalr . Type of Project; ^New__Addn Alteration•Repair <br /> ShoWNufiberJW)offlxfuresSimi limberly offixfures <br /> A/C—elr handling units - Toilet <br /> Forced air systemsBathtub <br /> Gad piping Levafory(wash basin). <br /> ater heater .Shower - ' <br /> Gas t)repiace Kitchen sink&disposal ' <br /> Gas range Dishwasher <br /> Mill Clothes8 Clothes washer <br /> . ■_ hood • Water heater <br /> =11111 Exhaust fan <br /> ' Sink(service7bar/mop/eto.) <br /> :. aacktlow:reventer inside bldg) <br /> Unit heater _ Urinal_ • <br /> Boiler I Drinking f=ountain • <br /> Refrigeration J Floor drain - <br /> r r. ■ 1 Grease hray T <br /> Ducting _ Roof drains T ' <br /> • Medical Gas <br /> --- --- RESSIe -- - - Other. <br /> NumberOther; <br /> • <br /> I hereby certify that I have read and examined ells application and know the earns in be true and correct-All provisions of taws and ordinances governing Ibis type of viorir wfl be complied <br /> with whether specified herein or not.The granting ore permit dada not presume to give Bulhopty la Violate or bencei the provision of any oilier stele or local law regulating conslniolion <br /> That I a,. - orfred by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1&27 ROW end 296.200A WAC. <br /> Owner •oL,orized ge t Signature Dale (Revised 4/2015) <br />