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Tc�: PaS�ea < c�i _� 20'1 �l-O'1 -L3 � 9.50:48 (GMT) 1•1L5:3GF3'1 S�13 Frcrn�: John Herzvg <br />� <br />� <br />�`■ ���� ��f ���� ■ ��� <br />BUILDINGlMECHANICAL/PLUMBING/51GNISPRINKLER1DEMt�L1TION <br />CITI( OF EVEFt�ii' I��RMIT SERVlCES <br />3200 Cedar St., Evereft, WA 98201 425-257-8810 FAX 425-257-8857 �nnrvw.everettwa.org <br />APPLICATIONS ARE LICCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: PROPERTY 7AX # P MIT <br />.r�r s' Z�� ,�� F��,��ztlT �'�2a_� _ c�oS"�� �3��� o� ��� - � <br />for new construcGon: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />ER <br />Phone/E-mail <br />Address �City/5tate2ip <br />APPLICANT. _ ONmer _ Owner's Agerrt h CO[ltf8Ct0� _ COf1Yf8Ct01'5 A�2Ri _ TEflatlt (mu3t prov�fe a Ictter o1 ccnsant hom the ownerU� tlo v.ork in the space) <br />CON7RACTOR � y�} s� OI"✓�G�i L& I Lic. # i'��_,��-�, t�W���,S 1..�'COE Bus. Lic. # <br />Address � }Z�(� � �%L��,�(��.,fx�-J � i�Vl�l � 'LS �d"'2.�..5 Phone/Email �L✓� '"' J"��..�'_�.�fs^�-� <br />TENAN7 E3U5lNESS NAME CONTACT FOR PERM17 ��vo�„a .jp��,,��,._� <br />� � � q°,�OP�.1�%�I °'�� �✓S�'/S�OJ"_ <br />PhonelE-mai! �`e;t1/n..g �4F,/Z/GN i$7 ✓�C3�/.+1�s, �'�✓/°'1 <br />�UlLDING PERNlIT APPLIGATION C�NTRAGT PRICE C}F WORK ?� �c�''E> �� �%'� <br />Existing Use of Building �� HEAT SOURCE: <br />P d U f B Id I`"�'S Gas Electric Other <br />ropose se o ui ing„_,__,_ — — — <br />Buiiding type� � Single Family � Duplex _Townhouse _, Multi-Famiiy _ Commercial <br />Type of project: New Addition X Remodel _ Repair __ 7.1. _ Sign _Sprinlder Demolition�Change of Use <br />DESCRIPTI ON OF WORK (additiana! space proWded on tha back) : <br />��— ���� �n ������� a r_�,�,� � ��.�� �_ �� ��_ � ���� <br />PL�-..��� e�-�� ��,s-- 3�s =-�'s✓.S ,�:��_ �..�ri e,aa�� ���-a <br />MECHANiCAL PEliMiT APPLICATION PI.U�TiBtNG PERMIT APPLICATIQN <br />Type of ProJect: _New_Addn _Alteration __Repair 7ype af Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fiartures Show Number (#) of flxtures <br />A/C – air handling units E Toilet <br />Forced air svstems Bathtub <br />Water heater <br />Gas fireplace <br />Gas range <br />Ciothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />__ _ <br />Refrigeration <br />W oadstov e <br />Ducting <br />Other <br />f SUPPRESSlO[V <br />Number of Heads <br />Shower <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbarl <br />Backflow prevent� <br />Urinal <br />Drinivng Fountain <br />F(oor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certiFy [hai I have read and examined this a pp4cation and know the same !o be true and correct. All provisior,s of laws and ordinances goveming this type cf vrork will be complied <br />vnth whelher specified herein or not. The granfing oi a permit does not presume to give authority to vio�ate or ca �cel the prwision af eny other st3te or bra! law regulating constructbn <br />That I am auihorized tr/ ihe ovmer of this property to per(orm the work ior which a�!pli�ation is marie and f comdy with the State Contractors i_aw 18 27 RCW and 2962p0A WAC. <br />`� r" �, � r; �� <br />OwnerlA thoriz gna Date (Revised G/2012) <br />