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Mar, 1, 2016 3 : 12PM No. 2089 P. I <br /> 0 0 <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 /> SITF ADDRESS: PR0PE1iTYT­ Il PG m T fbb-olog <br /> LEGAL for new construction: Short PlaUSUbdIvIsion. No. (attach copy of long legal description) <br /> OWNER Phone/E-111111 <br /> V, <br /> mi <br /> Addrp <br /> 311A. <br /> city/Slatc/Zlp (k <br /> APPLICANT; Owner Agent 'Kcontrictor ---contractor's Agent Tenant(niust piuvidti u lultef orconeem from IhA mM�rtn dnvnng in the space) <br /> CONTRACTOR <br /> Istate Lic. <br /> -..,Clty BUS.Lic.9 <br /> Addruss <br /> li'lione/Emall <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> P�&WF-rnajl <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCP <br /> Proposed Use of Building Gas. ..._ Elentric Other <br /> Building type: _Single Family —Duplex—Townhouse Multi-Family _Commercial <br /> Type of prolect: ­.....New —Addition Remodel --Repair T1._Sign_Sprinkler_Demolition Change of Uso <br /> DESCRIPTION OF WORK(additional spuuo providod on ill,-bick): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: —New—Addn �Altoratlon—Repair Type of Project: _Now_-Addn _.Alteration_Repair <br /> Show Number(4)of INturos Show Number(#)of fixtures <br /> A/C..•air lietridling units Tolle( <br /> Forced airs stems bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas i-ange Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water hoater <br /> Exhaust fan Sink(s rvicalbarlinop/etc.) <br /> He-at purnp Backflow proventer <br /> Unit heater Urinal <br /> Boiler Drinking rOUntaln <br /> Refrigaration Floor drain <br /> Wood6tovo Grease trap <br /> DUCting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> INumber of Heads Other,. <br /> I hcrnhy codify that I have read and emminod IN-. know the same to be true and correct.All prnviuiuris ofilws and ordinances goveming this type,of work Will I)e minjil <br /> willi whether specl1tBd h6refn or not.Tho Dialkliflo of a peel"Alt does not presume to givo al.1tholity to 0613le Of cancel the provision of any othor*till('PC 141cal I;1w letililali,IQ COASIrUetion <br /> That I 8!V1 'th"""i by the awn.r or this property to perforin tho work for which application[a made and I cornpt/wlth tho Stato Cartimcloir.Law 18.27 RCVV and 296.zuuA WAG. <br /> Owner/Authorized Agent Signaturo Date (Ravispd 9/201,/) <br />