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DEC/30/2015/WED 11 : 29 AM Greenwood Heating FAX No. 206 462 6216 P. 001/002 <br /> III • <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO rt PM I 6 --1 <br /> SITE ADDRESS: fPROPERTY TAX ti PERMIT# <br /> 6-60l CO ANed k 5 I Cx 75cnI 10500 Al 1 5�Z- 'L1 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 11i& SCaiCiS Phone/Erna ('- 2 ) 21b--5 1 <br /> Address `J I Colbi Ave_ 105 City/State/Zip E i - GR2O� <br /> APPLICANT: Owner _Owner's Agent Contractor Contractor's Agent _Tenant(must provide a letter of comment from the owner to do work In ana apace) <br /> CONTRACTOR �vter �i{/1i(,It I 4-C. L&I Lic.#6 P FEN t44- 21;) COE Bus.1Lic. ii0A3(1 $S <br /> Address 47-5-3 SOC ST ` J`T'>ZQ f Lu� `Tt-�3 Phone/Email (zap) 7l�[`is L r' <br /> TENANT BUSINESS NAME J CONTACT FOR PERMIT <br /> Phone/E-rnall <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK aQCU <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electrick Other <br /> Building type: : Single Family Duplex_Townhouse Multi-Family Commercial <br /> Type of project: New __ Addition Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> reOetc . QkkCk-Vcc_ OuVYwLCe_ , <br /> clew y 4& $ - tO k-vv' <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION f <br /> Type of Project: )(New_Adds _Alteration_Repair Type of Project; New Addn Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <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 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 /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains _ <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> INumber of Heads Other: <br /> I hereby certify that I have read and examined this application and know the eame to be true and correct,Alf provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW end 296.200A WAC. <br /> �i or IZ �b W7Lrk) Oj <br /> Ow er/Authorized Agent Signature Date (Revised 6/2012) <br />