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Nov, 17, 2015 7 . 45AM No. 0886 P. 2 <br /> 10 0 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTYTAX tt P IT <br /> LEGAL for new wnstructloll: Short Plat/subdfvlslon, Lot No. (attach copy of long legal description) <br /> OWNER �tva), <br /> Address .. <br /> APPLICANT: Owner _Ownar'sAgurt Contractor _......Contraetor'sAgent _Tenan#(musteravid;alntlnr of cucerrtiioin}ieout9rtorovmrklntnn:Pncn� <br /> CONTRACTOR (,.:/4 State Lic.# �"!!,> :rk ( ( ( (City Hus. LIC.fl (!���.•' <br /> Address h: Phone/Email <br /> TENANT BUSINESS NAMP CONTACT FOR PERMIT <br /> Nho1 !.Y:-mail �,,,.,.... <br /> l <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 6)c 0, Or—s <br /> Existing Use of Building HEAT-SOURCE; <br /> Proposed Use of Building -_ Gas Electric 011ier <br /> Building type' _Single Family _Duplex_'townhouse Muiti-Family _Commercial <br /> Typo of proje& New Addition Remodel Repair T.J. Sin Sprinkler 0ornolitiotl_Chan e of Use <br /> DESCRIPTION OF WORK(addlllollai space provided on the bark): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICA'T'ION <br /> Type of Project; _New_�LAdttn `_Altoratlon_Repair Type of Project: _New....... _Alteration_Repair <br /> Shaw Numbor d of f/xfures Show Number 4)of fixtures <br /> A/C–air handling units Toilet <br /> Forced airs stems 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 (7r-vice/bar/mop/etc.) <br /> I-Iaat purnp Backflow preventer <br /> Unit heater Urinal <br /> Boller Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease tra 7 <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hr-raby ceilify Ih.1 I have read and examinod this application and knew tilt.same to be true and correct.All provisions of laws and ardin;n,rr.:govrudug tills type of work will be comps <br /> WO;whether ppe¢i ed hereln or not-'E ha granlin0 of a p+amit dors 4101 presume to give authority to vlolato or canccl#tin piovi:�iun of Orly olher state or local law regulating construction <br /> The tall a Ifir lad Ly tho owner of thi.s property 10 Pei 10'111 the work for which application is mr;rio;q Pt I annply with the State Contractors Law 18.2/ROW and 206,900n WAC. <br /> Owner/Authorized Agent Signature I (Date (Rovlsed 9/2014) <br />