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NOV/02/2015/MON 12: 51 PM North Creek Roofing FAX No, 425 487 6524 P, 001/001 <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 S AM TO.4 PM <br /> SITADDRESS, PROPERTYTAX# <br /> LEGAL_for new construction: Short Platlsubdivision Lot No. (attach Copy of long legal description) <br /> OWNER Phone/E-mail <br /> Addregy lZ CP c City/State/ZipE v <br /> APPLICANT:—Owner _owner's Agent Contractor _Contractors Agent Tenant wast provide a latter of oonaent from the uwnerw do worn In the space) <br /> CONTRACTOR <br /> � t1Q 1 C� �7 p,A 1 L&i Lic_Q# COE Bus.Lic. <br /> Address,Vt vvU �N\i\� KA rC� rt 1"\t 1ICt QR� lyal Phone/Ernail WZ f �j�- f`.g <br /> TENA 7 BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 'A 2,�-'� - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> E=xisting Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other <br /> Building type: )�-Single Family —Duplex,,,,,,,,,Townhouse _Multi-Family —Commercial <br /> Type of project: New Addition X Remodel Repair T_I. Sign S r`inkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additionalspaca provided on the back); <br /> -%T' V^ 't r�Q� Co Vv� S k� �Y�b Fes¢- v�� <br /> .tt C-Q5 n tT i Ovl" 4&6f4� <br /> MECHANICAL_ PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn Alteration_Repair Type of Project: _New_Addn _Alteration Repair <br /> Show Number(#)of ftxfures Show Number of fixtures <br /> A/C-air handling units Toilet <br /> Forced airs stems Bathtub <br /> I Gas piping Lavato wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&die osal <br /> Gas range Dishwasher <br /> Clothes d er 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 /> Ducting 7 Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads other: <br /> I hereby certify that I have need and examined this application and know the same to be true and correct.All provisions or laws and oodinancas governing this type orwork will be compried <br /> with whether specified herein or not.The granting of a psmril does not presume to give suthorfty to violate or cancel the provision of any other state or local law regulating construction <br /> Tnat I am authorized by the ownerof this propertyto perform the wprk forwhich application is made and I comply with the State Contractors Law 16,27 RCW and 296.200A WAC. <br /> fh l/ zeLT <br /> 0 her/Authorized Age atu Date (Ravised 6/2012) <br />