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Nov 05 15 10:09a <br />� <br />� J <br />p.1 <br />� PERMIT APRLIGA�"10�1 <br />BUILD111�G/MECHANICAL/PLUMB#IVGISIGN/SPRINKLERIDEMOLiTIO�V <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Evereit, WA 98201 425-257-8810 FAX 425-257-8857 wwv�r_evere#twa.org <br />�� � ��C.'Y�[C-�Y L 1 1' L ��l. �PRQPER7Y7AX# <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal descripiion) <br />OWNER l.,%(.LV� NIUL.��'� Phone/E-mail <br />Address � l„� J'� � � � ` ! � �� City/State2ip � -Q/�i� �� � � <br />APPLICANT:�Owner ,OwnersAgent ontracfor _Contractor'sAgent _Ten2nt(m�s�proviaeaieueroreonson�rranmoawnerbdowo.�cinmaspa�� <br />CDN7RACTOR � �� �l ''�� l'1%' State Lic. # � �" us. Lic, #d4�'�`-I � <br />4ddress �� � � ���4�41 �� ':��; � Phone/Email - "�� ��� � <br />TENANi BUSI�[ESS NAME CONTACT FOR PERMIT <br />� 1tiOI'��� �'fiYG�1 h,GL Gr�(,�'Vl (,G'L��'a Yu2� <br />PhonelE-mail � <br />6UILDfNG PERMIT APPLiCAT�ON <br />PRICE OF WOR1C <br />Existing Use of Bui�ding � <br />Proposed Use af Buildinq <br />Building type: � Single Family � Duplex _Townh�use _ Multi-Family _ Commerciaf <br />Type of project; New Addition Remodel � F2epair_ 7J. ,� Sign _Sprinkier <br />DESCRIPTtON OF WORK {additrona! space provided on the back) : <br />���5 i-C�,� (�L�l r�-� SS �l�[�-f— � �-�-��-� <br />MECHANICAL PERMIT APPLICATION <br />TypeofProject: _New_Addn l�Alteration____,Repair <br />ShowNumber(#J offixtures <br />A/C — eir handling uniis <br />Forced air systems <br />Gas piping <br />Water heafer <br />Gas fireplace <br />� Gas range <br />{ Clofhes dryer <br />F�chaust far <br />Heat pump <br />Unit heafer <br />Boiler <br />Refrigeratic <br />Woodstove <br />Ductinq <br />SPRINKLER / SUPPRESSION SYSTEM <br />N�mber of Heads <br />,� <br />HEAT SOURCE: <br />Elec#ric Other <br />af Use <br />PLUMBING PERMIT APP�ICQT(ON <br />oi Project: �New _addn _Atteration �,Repair <br />Show Number (#� of fxtures <br />8athtub <br />Lavafory (wash basin} <br />Shower <br />Kitchen sink 8� disposa� <br />Dishwasher <br />Clothes washer <br />Water heafer <br />Sink (servicelbarlmopletc.) <br />Ba�kflow preventer <br />Elrinal <br />D�inking Fountain <br />Floor drain <br />Grease trap <br />Roof drains - <br />Medical Gas <br />O#her: <br />Other: <br />I hereby certify lhat I have read and examined this application and know She same lo be lrue and correct. All provisions of laws pnd ordinances goveming this type cFwork will be complied <br />�v1lh whather spe�c3q herein or not. The granting of a pemM qoes not presume to give authorAy to valate cr cancel the pwvlslon of any ather state or local iaw regulannq rnnsvuciia� <br />That 1 m aulhorizad by the owner of lhis proparty to pe�form 4i � wo�k io� which application Is made and I cempFy v+ith the Slate Conlractors �aw � 827 RCW and 296.20QA WAC. <br />� �.� <br />OwnerlAuthorized Agent Signature Date {Revised 3/20i3) <br />