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425-252-1666 CM HEATING 04:06:20 p.m. 03-25-2015 2/4 <br />• � <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMB�NG/SlGN/SPRtNKLER/DEMOLiTION <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evereffwa.org <br />SITE ADDRESS: PROPERTY7AX# P RM T <br />0 �' <br />LEGAL for new constructian: Short PlaVsuhdfvislon Lot No. (attach copy of iong lepal description) <br />OWNER i� w(�; i� Phone/E-mail �j 5� �7 <br />Address CIty/5tate2ip <br />APPLICANT: _ OWner � O�mers Agent � Contra�tor _ Contraators Agent T8�8T71 (must pmvido a lotterof consent from �10 owner lo da work In the apar�) <br />� <br />CONTRACTOR L+, � �(' State Lic. #� �i��q��y" City Bus. Lic. #�`�(� <br />Address r'O ��� w�i' qg%Q� Phone/Emaif �'� 2�9 �LL� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />p��,l��o.�e, �25 25Q �►or��o : <br />ne/E-mafl � . (�Q� <br />BUILDING PERMIT APPI,ICATION coNTRACT PRICE oF WORK S3�a3 <br />Existing Use of Building HEAT 50URCE: <br />Pfopased Use of Building Gas Electric Other <br />Building type: _ 5ingle Family _ Duplex : iownhouse _ Multi-Family _ Commerciaf <br />T e of ro'ect: New Addition Remode! Re air T.L Si n S rinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additienal space provided on the back}: <br />1 nS-}u,l l c�x.-�(L°55 hQG�' �� �° <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Typo of Projoct: _Nnw ^Addn _Atteration _Repair Typo of Pra]oct: _Now �Addn _Alteration _Repalr <br />5how Number #J of rxfures Show Numbcr # of flxtures <br />A/C - air handlin units Toilet <br />Forced air s stems Bathtub <br />Gas i i� Lavato wash basin <br />Water heater Shower <br />Gas fire lace Kltchen sink & dis osal <br />Gas ran e Dishwasher <br />Clothes d er Ctothes washer <br />Ran e hood Water heater <br />Exhaust fan Sink service/bar/mo /etc. <br />1 Heat um Backfiow reventer <br />l)nit heater Urinal <br />Boiler l7rinkin Fountain <br />Refri eration Floor drain <br />Woodstove Grease tra <br />Ductin RooF drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other. <br />Num6er of Heads �ther. <br />! he�ehy cedify that I have read and examined ihie appUcation and know lhe sama to be true and corcect. AI! provisiane of laws and ordinances poverning this typa of wark will ba compi <br />with whether specified hereln ar not. Tha Arantlng of a permlt dnes not presumn to give aulhority to violata or cancel the prnvisfan of any other stata or loca� taw regulating constnrction <br />Thal i¢m authonzed by tha awner of thls property Io periorm thc wark for which appfication Is made and i comply wlth the Stata Contradors Law 18.27 RCW and 296.2DOA WAC. <br />► � �•25•15 <br />Owner uthorizad Agent gnatur[t Date (Revlsed 92014J <br />