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MAR/02/2016/WED 01 : 53 PM North Creek Roofing FAX No, 425 467 6524 P. 002 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/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 /> SITE ADDRESS: Y`V t PROPERTY TAX If �t PMMITC �) <br /> Lv , <br /> LEGAL_for new construction; Short Plat/subdfvision Lot No. � C(attach copy of long legal description) <br /> �OWNER v h-� PhoneJE,mail W ^2 q T <br /> Address kJ City/StatefZipW A g-L1,0 <br /> APPLICANT'_Owner _Owner's Agent Contractor _Contractors Agent _Tenant f nest pravioc a letter of consent born thl annerta do wot In Na sp;o2) <br /> CONTRACTOR t/C,r t 11L(&I Lic.# � 41 COE 131S, U..#'M7-750t f <br /> Address Vv\�\ C` L 2 ``\l�Q(L Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone1F--mail l-ks T JIV <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Yj 3 2 <br /> Existing Use of Euilding HEAT SOURCE: <br /> Proposed Use of Building Ges Electric Other_ <br /> Building type; Single Family Du lex_Townhouse _Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.J. Sign Sprinkler_Demolition_Chane of Use <br /> DESCRIPTION.OF WORK(additional space provided on the back): <br /> Q-Xr bf C awl p r o p -ft"r i rl S t-n. -Q-�-v �►��. r v d t' <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn —Alteration_Repair Type of Project: _New_Addn Alteration_Repair <br /> ShowNumber of fixtures Show Number(#)offlxtur" <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ran e Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc,) <br /> (-teak PUM2 Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refriqaration Floor drain <br /> e Woodstove Grease tra <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other. <br /> Number of Heads Other: <br /> I hereby certify(hat I nave read and examined this application and know the same to be true and coned.Alf provisions of laws end ordinances governing this type of work will be complied <br /> with whether specllied herein or not.The granting or a permft does nut presume to give authority to violate or cancel the provlston of any other state or local law regulating construction <br /> That t am authorized by the owner of this property to perform the work ror which appllcalJon tg made Wnd I comply with the State Contractors Law 18.2)RCW and Z56.200A WAC. <br /> daloz -�1b 4 1-11 , 15 <br /> ner uthori Agent Signature Date (Revised 6/2092) <br />