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PETZMIT APPLUCATiON <br /> k3IJILDING/MECHANIMAL/PLUMBING/SIGN/SPRINKLERIDEMOt_ITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Si, Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everethva.org <br /> 0-451-5- <br /> SITEt ADORES * -,..., „...4---------- PROPERTY-TAX It — pai4,. <br /> 1 4.,,ti re..a141,11611 ..........manottoomumms, / *. 0121.-- <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of tang legal description) <br /> i-.-----i........i.....i...--...-*,------.—.......-,--,i-i........- <br /> OWNER <br /> 1enerrLtion Q, LLC Phone/E-mail f4.,3 1 .e ....a.--1- -asi,ctYn. <br /> Address Po acpK___5c)C city/state/zip , <br /> APPLICANT OWilf,!r Owner's A 9ent Contra eel' Contractor's Agent Tenant(mem wayee a testi of trapenIttem Int Vtr,t;ID dp Tf0;in te tip* <br /> vim •••••••••WM•••••.8.0111.1.1.1 <br /> CONTRACTOR CO IQ f f terit2,44. — State Lis # City Bus.Lio if- <br /> ,A.deress Phone/EMI) <br /> , <br /> -- <br /> TINANT13USINE5S Nam - - -CONTACT FOR PERMIT <br /> --- • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building ... HEAT SOURCE: <br /> / Proposed Use of Building Gas ___ Electnc_ Other, ., <br /> Building type: Single Family Duplex__Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel _ Re air T.I _ Sign Sprinkler_J)ernolition Change of Use <br /> DESCRIPTION OF WORK(odd:bon&space pmv,Vcd on the back): <br /> :4* t\d/COO C*of O. v v 1 r W 1i 1 4 N E.it, 0 cc_ v rA tvi- L04-0 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION 1 <br /> Type of Project: Now Addn Monition Repair Type of Project: New Addn Alteration."__Repuir <br /> Show Number(#)of fixturos Show Numter NO of fixtures <br /> NC-air handling units Toilet .. <br /> Forced air systems bathtub _ <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> _ ... <br /> Gas fireplace Kitchen sink.E.disposal <br /> Gas range Dishwasher <br /> . — <br /> Clothes dryer Clothes washer - <br /> . <br /> Range hood Water heater _, <br /> Exhaust fan Sink(service/barimopietc.) <br /> Heat pump backflow preventer(inside bidg) _ <br /> , — <br /> Unit heater Urinal <br /> 1 Boiler <br /> _ Clinking Fountain <br /> I- Refrigeration <br /> Floor drain —_-- ... <br /> ... <br /> 1 Woodstove Grease trap -, <br /> . --, <br /> I Ducting Roof titalf15 — - - <br /> I Other __......_ Vedical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> ,-. <br /> Number of Heads Other <br /> I hereby ceri ity that I bow read and examined this application and knew the same to be true and cooed.All provisions of laws erd ordinance?:governing Ibis lypo of walk wit be complied <br /> with whether speared herein or het.The granting of a petrol goes net presume to give at:Meaty to vloiale or cancel the provisien of arty other stale Of 10t4 taw re9t4Iing boostrueron <br /> That Ice authonzed by the owner at ells property to perform the wottt ter which opprzASoo le made and I compty with Ilia State Contractors low 112,7 RCW and 296,200A%VAC, <br /> N Ne / j _,, <br /> ce ioit <br /> 0 neriAtltiiatiZed Agents gnature Date (Re Vaud 4/2015) <br />