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425-252-1666 c.m.heating <br />12:33:55 11-24-2015 2/2 <br />� � <br />� a���iTl� 1 !'11 � L.IV!'11 IVIr <br />BUILDING/MECHANlCAL/PLUMBING/SIGN/SPRINKLER/DEMOLIT(ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 NnNw.everettwa.org <br />tAUUliCJJ, �"�O � �1 IV� �� IPROPERTYTAXk ' Y� ����I�� V ✓-1 <br />�` .J <br />iAL tor new construction: Short PIaU�uhdivi;ion Lol No. (attach copy of long legal dascnpfion) <br />NER �/�h--_I-� � d Phone/E-mail� 3- a <br />ress L�U v`� �� � CilylState2ip Wr] I�� <br />'LICANT: _ Ov�nar _ O�•mer's Apent � Contractor _ Confractars Agenl Teflafli (rr.ust pn�IJs a ietter cl cn�act h�m U'e axr,er tn d� �cx;n ve spa�a; <br />VTRACTOR Q, t � L State Lic. #� -1J7�`v'15�� City Bus. Lic. #�`�U <br />ess � ro �-Q��� ��'C q g�� Phane/Emall �'� 25q �Q�� <br />IA��T BU5INESS NAME CONTACT FOR PERMIT <br />��,y�,��, �25 z5� ����. <br />�fiane/E-mall j � �� <br />�ILDING PERMIT APPLICATION CONTRACT PRICE OF WORK J a� D-.. °� <br />ting Use of Building HEAT SOURCE: <br />�osed Use of 9uilding Gas <br />iing type: _ Single Famify _ Duplax _Tov�rnhousa _ P�tulti-Family _ Commercial <br />> oF project Naw Addition Ramodel Rapair T.I Siqn Sorinkler [ <br />iCRfPTION OF WORK (additionalspace prnvided on tne bacN): <br />���-�-Ce� CS� S ��� C�— <br />PLUMgING PERMIT APPLICATION <br />e ot ProJect: _Naw `Addn _Alteratton _Ropalr <br />ShawNumbcr(N) o/Txtu�es <br />� Tailet <br />� Bathtub <br />� Lavatory (wash 6asinl _ <br />' � Shower <br />� Kitchen sink & dis osal <br />Dishwasher <br />MECHANICAL PERMIT APPLICATION <br />iofPraject: _Naw_Addn �Altc <br />ShowlJum6er(#) afrxturf <br />� A/C — air handli <br />Forced alr svstf <br />r heater <br />Gas <br />Gas <br />ttartge nooc <br />Exhaustfan <br />Heat pump <br />tlnit heater <br />Bailer <br />Refrigerati❑ <br />Woadstove <br />tlon _Repafr <br />units <br />Chanqa of U�e <br />Water healer <br />51nk (service/i�ar/m <br />Backflow preventer <br />Urinal <br />❑rinkinq Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />� Other Madicaf Gas <br />SPRINKLER / SUPPRESS(ON SYSTEM Other: <br />Number of Heads Other. <br />e6y certify that I have read and naamined Ihis applicaGan and know Ihe eame to ha Vue and carred. All provisiana of la�Hs and ardinances 0overning this tYpe of wark wil! 6e comp: <br />whether apecified herein or noL Tha p ran6ng of a perm�� doas nol presuma la give authoriiy to violate ar cancel the pmvision ol any other atela or tacat la�n regulating canstrucfion <br />I am euthorized 6y the owner af Ihls property to peRorm lho work tor which eppfication le mada and I camply with Ihe Slele Contractors La�N 10 27 RCW and 29fiZ�0A WAC. <br />1 ` � I (RQvised 9/1014) <br />nar uthorizod Agnnt gnaturo ate <br />