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DEC/30/2013/MON 01 : 27 PM Right On Heating FAX No. 425 334226 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 wvvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> A DRESS: PROPERTY T x# P IT , <br /> a 1 oo 0606a906 <br /> 2- <br /> SITE -07 <br /> LEGAL for new construction: Short Plat/sub <br /> rdiv <br /> ision Lot No. (attach copy of long legal description) <br /> OWNER b o cx m S W 00 tA om— Phone/E-mai( <br /> Address -5 0.M t�-5 Q b S.; City/State/zip <br /> APPLICANT: Owner _Owner's Anent _Contractor Contractor's AgentTensnf(must prcvlde a Ictterol consent from the owner to do work Um spsen) <br /> CONTRACTOR kt DA �- Sh e ,:&Z45&I Lic_# R f G HTN M 4g9cAcou <br /> L'E Btis. c,# <br /> 7 a3 9 G <br /> Address PO `E-9- �pg1 3. 3r� ,/ IJF .t-&AC St�e-✓ell S W Z._ I Phone/Email as ��S' [aZD7 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT /opt �e Ca►tit <br /> f't �"C o✓1 e� r <br /> ►n/1 <br /> Phone/E-mall 1- Ct vi 1-e _ �lS rjj`S- a 7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0 0 4 <br /> Existing Use of Building HEAT SOURCE' <br /> Proposed Use of Building Gas Electric Other <br /> Building type; _Single Family _Duplex_Townhouse _Wltl-Famlly _Commercial <br /> Type of roject; New Addition Remodel Repalr T.I. Sign_ -Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the tack)! <br /> C 0 N �/e ✓' $ i 4(/1 —ro It'd 0.f, C�$� t ,2 5 �c� �� c� o �► C� C�� �u �►cc Ct� f�) <br /> G],as p ` P ;ng to wtle. ,- Hae-, c, -«- !o d-t.,c* r" e) S Cf-kiee-fAne )t <br /> 0 MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of PTQJeCt' _New_,Adan 77lteratlon Repalr Type of Project: _Naw_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Nurnber(#)of fixtures <br /> AIC-air handling units Tollet <br /> Forced alr systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> 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 /> Boller Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that i hava read and examined this application and know the some to be true end correct.All provisions of laws and ordinances governing IN*typo of work wIG be complied <br /> with wh6th®r spccifgd herein qr not.The granting ofa permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> Tnat I am authorized by the owner of thls property to perform the work for which applteation is made and I comply with the Stats contractors Law 18.27 RCW and 296.200A WAC. <br /> 1,3 <br /> Owns uthorlxed Agent Signature Data (RGOsed 612012) <br />