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425-252-1666 c.m.heating 14:45:04 11-25-2015 3/4 <br /> BUILUIIVt,7/ivtc1-FrIANIUAL/I* IVItJINu/51UN/SPRINKLERIOMULI I MN <br /> CITY OF RETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vN'-N.everett',va.org <br /> 111" <br /> PQ62' � � � PROPERTY TAX# PE n,1T, 1 <br /> L for nevi construction. Shhoort Fiassitdivfsion Lot tlo (stta:h copy of tong le391 descr pion) <br /> :R <br /> -c `�d � ayrstat�rzio �arJ <br /> SANT:_Ov:ner _0%vner's Ag=_nl V/Contra=tor _ Cor,trastar's Agent ^Tenant{veer,,.�rua s enerr�r:r:rt rr- rar i .c,<nr9 ra:a <br /> FACTOR Q ` (. �A� nnS7tattleLic.# � 095��- CityBua. Lice #81bo <br /> �L1 I v '}bf+�' PhonefErnail 425- 209 LOW <br /> IT BUSINESS NAMECONTACT.FOR PERMIT <br /> �� e, X25 25R l2lplo>A. . <br /> Y1 •tDY" <br /> DING PERMIT APPLICATION CONTRACT PRICE OF WORK ,Z::�a '4 a 7a <br /> Use of Building HEAT SOURCE: <br /> !d Use of Building Gas , Ba.tric Clear <br /> type: _Single Family _Duplex_To.vnhouse _Multi-Family —Commercial <br /> rojecL Ne,v Addition Remodel P,_aair T.I. Sin 5orinkler Demolition Chan e of Us: <br /> ZIPTION OF WORK(9jdit;onal spa e pr vidad cn the bacs): <br /> IECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> rroject: _Naw_Addn � Alteration_Repair Type of Pro)oct: —Ne•w_Addn _Alteration_Rapair <br /> Show Number(#)offixtures Show number(M)offistums <br /> I A/C—air handling units I Toilet <br /> I Forced air systems ( Bathtub <br /> ( Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace ( Kitchen sink S disposal— <br /> Gas <br /> is osalGas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mop/etc.) <br /> ( Heat pump I Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinkinq Fountain <br /> Refrigeration ( Floor drain <br /> ( Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> PRINKLER/ SUPPRESSION SYSTEM Other. <br /> Number of Heads Other. <br /> My that I have read and examined this application and knmv the same to be true and correct AJ provisions of lays and ordinances governing Ihls type cf workwin he comp <br /> ar specified herein or not.The granting of a permit does not presume to give authorty to violate or cancel the provision of any other scala or local tav regutat:ng construction <br /> ruthorized by the owner of this property to perform the work for which apFlication Is made and I=mply with the State Con"a-tors La.v iB 27 R--w and 296 200A wAC. <br /> lut -t` � ,, �1 t <br /> uthorizad Agent gnatura Date (ftevised 4/2014) <br />