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Nov, 30. 2015 4: 12FM No. 1033 P. 2 <br /> 0 0 <br /> PERMIT APPLICATION <br /> BUILD]NG/MECHANICAL/PLUMBING/SIGN/SPRIN KLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32.00 Cedar St., Everett, WA 98209 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRES : PROF01'rL' --) P MIT## <br /> LEGAL.for new mnatruution: Sliort Piwisuhdivision ...—Lot No._,,, (attach copy of long legal de-tcripticn) <br /> �I <br /> OWNER G) !•"}�r) , 1 �Z71.�- ,.���� PnonelL-111311 �� - <br /> Addrenn <br /> APPLICANT: .,Owner _Owner's Agent Contractor _.Contraotor's Ageot _Tcnant(muslpmvldea letter&Lvmu,ii frontihn nvgnrin do—kintha rpaw) <br /> CONTRACTOR StateLic.# �:i�,�.` �C..-�' •. City liuS. LiC. <br /> Address <br /> TENANT BUSINESS AIME CONTACT FOR PERMIT l <br /> Phone/l'-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Huildiny _ ,,,.., HEAT SOURCF-: <br /> Proposed Usc of Building_.., .... 1 Gas, ..— Electric Other <br /> Building type; _,... Single Family _Duplox_Townheuse Multi-Family _Commercial <br /> Type of project: New Addition Remodel Ro air T.I. Slyn_Sprinkler Demolltkou_Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the bark): <br /> -6v vvia,,) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of project, _New Addn Alteration__Repair Typo of Project: _New_Adds _Alteration_Repair <br /> Show Number(tt)of fixtures Show Number fl of fixtures <br /> A/C—alt handling units Toilet <br /> Forced alts stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchon sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clolhes washer <br /> Range hood Water fznaler <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> HGat pump Backflow preventeF <br /> Unit heater Urinal <br /> Boiior Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstovo Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads Olher: <br /> I heroby rr>rtify Thal I have read and oxamin(d 00!;:,pt)llcatton and know thr,;:;erne la be Ifue and corroct.All prnvi!:inn::of Taws and ordinances govimiinp Ihls type of work VAN he rnmpl <br /> with wht:lhcr.-.proirad hereln or not.Thr.ganding or s permit dooa not winuirrte to ylve authority to violate ar cant:el lite p(ovlslon of any other:state-ur local law repulating carrdrurtian <br /> Thai Ism aulliodzed by the owrim of this property to porfonn ttr0 work ror whole application i;made and I comply With the Stute Coniraulore Law 18.17 KCW and 299,200A WAG. <br /> Owd'ur/Authorized Agent Signature Date (RuviSLUt12014) <br />