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MAR/03/2016/THU 11 : 30 AM North Creek Roofing FAX No, 425 487 6524 P. 002 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 WWW.everettwa_org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITZ: D KESS: _ PROPERTYTAx#I P WHIT#„ <br /> t1 Vi 19 T7 Y-Jc Aalg, <br /> LEGAL for new construction: Short Plat/Subdivision Lot No. (attach copy of long legal description) <br /> OWNERj Phone/E-mail <br /> Address l-(t- `,� A/y--S - City/State/zip yL k- O <br /> APPLICANT:—Owner _Owner's Agent xCantractor _Contractors Agent _Tenant(muetrprovide a latter of mnsent ham the owner to do work in the sp.c) <br /> CONTRACTORrU\ QQ4� � L&1 Lic,#I V L ZC COE Bus. Lic. .63259 <br /> Addrell 4� Mkk(l Ct(Z �-Zko 8`` t� m (_red( Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail (JL�Q t��1ILCi �lC'�LtL�C V tse�pt r-�• Lv.� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK , <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Etectric other <br /> Building type: _Single Family _Duplex—Townhouse Mufti-Family _Commercial <br /> Type of project: New Addition Remodel Repair_T.E._Sin sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> V \:�A- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: ,,,,_•New__Adds Alteration_Repair Type of Project: _Now_Addn _Alteration <br /> __Repair <br /> Show Number(#)of fixtures Show Nucober # of fixtures <br /> A/C-air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> f Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ductinq Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number of Heads Other: <br /> 1 hereby certify that I have read and examined this application and know the same to be we and correct.AA provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate orc,nCol the provision of any other state orlocal law regulating construction <br /> T iel I lle�un.Vc,orallt�!'vt"�''lr lv Mr,rvr•Ura�••v3rllv�•a•I i�i„li 7� <br /> <odz:� ' ntSig nturo aNrrliw <br /> llvri(a rrraJc aitU f wiiiNly rvttli(riy Old le GVIIU OVIVJ LCw IO.LT RGVY tlI1rV <br /> Lb O.GV VM VVNI,. <br /> Date (Revised 6/2012) <br />