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JUN-11-15 04:01PM FROM-COVERT ENGINEERS 15036030996 T-987 P.04/05 F-287 <br /> pL,r-- ID I1 &YI <br /> PERMIT—APPLICATION <br /> BUILDING/MECHANICAP. .UMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY O RMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa-org <br /> I 3r <br /> SiTEADDREE5; PROPE'TYTAx PER., T# <br /> ,. I ?0� a fK�1L-L �K41r�- I-/ Y -3 t.� Li {i <br /> c;G; D i <br /> LEGAL for new construction: Short Plat/subaivislon Lot No. (attach copy of long legal description) <br /> OWNER /f 4 D l,,,-tk12tpi2 lc,L'S Phone/E-maH5_Scx S(4)(.G,1CGS e. 'let <br /> Address 0 (&)7. p (W 3\ CityyISttate/Zlp V., i>N✓n p(7` Ll U dg <br /> APPLICANT:_Owner y Owner's Agent Contractor Contractor's Agent Tenant(mat provide a icier of caneant from mo owner to do cork In ma opoca) <br /> CONTRACTOR State Lic.,# City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS E CONTACT FOR PERMIT -i' 5 z+`j,ce�: GV/J04- <br /> 1/�I t7f.A/i S,F r,)ForiOS ( ' 4/7 ,/ �v�E/zr ,��ti6 S .Nc. <br /> Phone/E-mail -66.3-C )/c4vcSzic,o%er.1- 4 G')codc_CCL rr.1r,,/Gi ,eorA <br /> BUILDING PERMIT APPLICATION CONTRACT PRiCE OF WORK <br /> Existing USE of Building t/26C,e-Si.1/C HEAT SOURCE: <br /> Proposed Use of Building //,1C(;SSi.✓CT Gas_ Electric Other <br /> Building type: Single Family Duplex Townhouse _Multi-Family Commercial <br /> Type of pro}ect: --„New Addition Remodel Repair__ T.I. Sign Sprinkler Demolition Cha ge of Use <br /> DESCRIPTION OF WORK(additional spate provided on the back): Jd�.Ji�1C� NRot/ TGj L$75'I 4 iv Sc i U,^�-e r <br /> /v S,ivic i 47 A67:1 l Hv� Gt' r if Oerhe�ZSl 4 6,t241( Raa,:-1 ct,, /K 1 Anvil <br /> ilk rvtoP si"i.� tiv-ib 4 ' W 3,760 SQ4r .,E /LOK6' sgz_vi:rLs .r,,o .b • <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _Now_Addn Alteration_Repair Typo of Project tNew,_Addn `Alteration_Repair <br /> Show Number(#)of fixtures Snow Number 1'#)of fixtures <br /> NC-air handling units i? Toilet - <br /> Forced air systems Bathtub <br /> Gaopiping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Rant e hood 1/ VAIV- -Waterhe" tiTyi r <br /> Exhaust fan /o _ Sink(senhce/bar/mop/etc.) <br /> Heat pump Backflow.reventer iinslde bkfp) <br /> Unit heater _ 2- _Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain -' <br /> r_ , Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: )41 4919 Sr.v6G <br /> Number of Heads Other; _ <br /> i hereby certify that I have read and examined this application and know the game 10 be true and correct.All provielona et Laws and ordinancea governing fila type of work wie be comp <br /> with whether epacllled herein or not.The grunting of a permit does not prec we 10 give uythorfly to violate or cancel the provision of any other State or local law regulating construction <br /> That i am Ou horQod b a Owner oT(hla propel perform the work Tor which appllcerian Ia made and I comply wOh the State Contractors Law 18.27 RCW and 2BB.200A WAC. <br /> ("<-4-'77_,,ar- ' c;2.------- 00.5---. <br /> Owner/Authorized Agent Signature pate (Revised 412015) <br />