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Nov, 30. 2015 3: 32PM EVERGREEN STATE HEAT & AC No- 5773 P, 1 <br /> OERMIT APPUCATO -0 <br /> E3UIL®ING/IVIECHANIC.AL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-2578810 FAX 425-257-8857 www,everettwa.org <br /> SITE Af�D SS: PROP�ftT(TAl(!} PP IIfiIT# <br /> LEGAL for new construolon' Short Plal/subdlvislon Lot No. (attach copy of long legal description) <br /> OWNER -CU'jT �) PhonefE-mail 1IS7) 9 Lf(o?v <br /> Address Z�3 l City/stete/7lp <br /> APPLICANT:—owner Owners Agent Contractor _ConlractoeaAgent _Ten ant(mUstprovdealei lei orconsentfrom lhmavnertodowork in;haepace) <br /> CONTRACTORV= (o ZfJ CI b4 [Qs A C- State Llo.#rG d 2 f<7 Cit Bus_ Llc.#pC1 <br /> Address Phho e Et12alll 3 t r <br /> T <br /> 2>.WO 4 �' - <br /> TENANT 133USINESS NAME CONTACT t'OR PERMIT <br /> KIM , L43 <br /> Phone/E-mall 5 <br /> 13UIL131NG PERMIT APPLICATION CONTRAC i PRICE OF WORK" �f q <br /> Existing Use of Suildiriq HEAT SOURCE: <br /> Proposed Use of Building Gas PleclrlC Olher <br /> Building type: Single Family _Duplex __"I'ownhousa ^Multl-Family _Commercial <br /> e of pro ect: _New _Addition _Remodel. Re alr_TJ._ Sign_Sprinkler Demolltlon�Chan a of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Cker N)F-e ouCT ak!l '�t'z VAI, <br /> MECHANICAL PERMiT,APPLICATION Pi.U1 BING ROM APPLIcAnom <br /> Type of Project: JTlew_Addn „ Aillaration„_,Repalr Type of Project' _,New_.Addn Alteration____Repair <br /> ShowNumber(tt)oftixtures Show Number(#)of%Jxtures <br /> A/C--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 /> Ranee hood Water heater <br /> Exhaust fan Sink(servicelbar/mop/etc. <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler aFloor <br /> f=ountain <br /> Refrlgeration inWoodstove aDucting nsOther Gas <br /> SPRINKLER/ SUPPRESSION SYSTIEM Other: <br /> Numbar of Heads Other: <br /> hereby certify that i have read and axamlaed Ihte appriealion and knowtho same to ba true end correct.AO provlelona ofla�vs end ordlnsfiees governing this type orlvork Will bo compllsd <br /> vrlth rtrelher speed herein or not.The granting ors parmtt does not presume(4gNe suthorily to violate or Cancel the provialon or any other slate or local lewregulating conatrucllon <br /> That I am authorized bthe owner or i any to perform tho Work for Y+hlch applieallon 1s made and I comply wvh the Slflte Contractors f,av110,27 nCW and 296.200A WAC, <br /> �� <br /> Ov✓ner/AK�ed' <br /> izAgent Signature Dale (f?evlsed 3/2093) <br />