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�1PR/14/2016/THU 11: 32 AM Nort,��ree[c l�oof ing FAX No, 425 48�6524 P, 002 <br />� <br />PERIVIIT APPLICATION <br />BUiLDINGIMECHANICA�./P�.U111fBING/SIGN/SPRINKLER/DEMOLITION <br />C1TY OF EVERE7i f'�RMI�' S�RVICES <br />3200 Cedar St., �verett, WA 98201 425-257-8810 FAX 425-257-885i www_everettwa.orc� <br />AAPLlCAT10NS ARE ACCEPTED FROM 8 qM TO � PM <br />4DDRESS: ���0 0��� 1��r, � PROPERTY TAX t# p�M� I n��n�� <br />�V <br />LtGA� fof ne�Y �ns�rctipn: Shorf PlaUsubdivigio <br />OWN�}� . �� � V�� <br />Address �3 ��,�i. <br />k <br />APPLICANT: _ Owner <br />CONrRACTOR <br />Address � lQ � � <br />z� U `Dn�J� <br />� <br />Owner's AgenC � <br />C� <br />6U[�D�NG P�RMIT APPLICA7�ON <br />Lot No. (attach copy of long legal description) <br />Pho�elE-rnail �{ Z� � � �� -- � p � <br />Ciry/State2ip <br />_ Contractors Agent Tenant (muat orov�ae e iener otoonasnt rmm tne rnmnr�o da.,rortc m tne soeca) <br />L& I Lic. #' C COE Bus. Lic. #y.43Z�� ( <br />'�Wt���1�C,1 17on6/Email �Z.� -`-�qZ��-G K(� <br />---- �- - - ---- ----��- ���--�-'�-r�n-� <br />PhonelE-mail 'Zj��- ��� "` �� � � <br />CONTRACT Pa10E OF WORK �0 , (�'��o • � � <br />ExisEing Use of Building <br />Pfoposed Use of guildinA <br />Euilding type: �irtgle Family � DupteX�Townhouse _ MUIt!-Femily <br />Type of project.- New Addition X F2emodel F2epair T.f_ <br />D�SCRIPTION OF WORK {adddiona(space provided on fhe back): <br />�Q��r o� c..�m p as��L � v� +r�� � � � � <br />��J ���. �os� � i U Y1 �'�`� <br />HEAT SQU�.CE: <br />Cvmmercial <br />__ Sprinkler DemoliYion Chanae of Usa <br />�-� \�.�.-Q. W�'�'� <br />M�CI-�f�iNIIGA� PERMIT AP��.�GA�'I��V �— PLUMBING PERM[Y I�1PP�tCATiON <br />ofproject; _New_/�ddn Alieration_Repalr <br />ShowNumber(#) offlxiures <br />� A/C — air handfinq units <br />Gas piping <br />Water heaier <br />Gas fireplace <br />Gas range <br />Gfothss dryer <br />Range hood <br />Exhaustf�rt <br />Neat.Pump � <br />Uni# heater <br />Boilef <br />r, Woodstova <br />Ducting <br />� Other <br />SPRtfdKLER 1 SUPPR�SSION <br />� Number of Heads <br />of ProJsct: _New Addn AFt@r�tion _RepQir <br />Show Nurnbci (ft) of f�rturss <br />j Toi�et <br />I Bathtub <br />Kitchen sink & c <br />DishWasher <br />Cfothes washer <br />Water heater <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Metlica� Gas <br />Other: <br />Other: <br />I neraby ce�t�y that I hsve resa sntl �zamtne� Nla applicaGon anQ know t�e seme t0 be lrue and carrsct. Aq vrovisions of lawa entl orolnences govemfng i�ls prpe oFwork wifl bs comvli�d <br />with whEthsr 3ptcifie4 herein or no(.'fTie granfing ot e pertnit does not A�s�me to give a�lhorib lo �iolate ur�ncsl the provisfon of eny other atate ortocai iew regulaSing congtrvdion <br />Thal � am s�thorized by tna oavner ot 1�(s property lo pertorm the worx �orwhfr,t� eppllca(lon ts mau� anQ I comply with tha Stata Contractors Law 18.27 RCYv end 2862ooA W,q�. <br />o� r � 1 � � <br />�:rLau �ori��d Age igneture Date (Revised 6/2012) <br />