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Feb,24. 2014 2;32PM EVERGREEN STATE HEAT & AC No,0162 P, 1 <br />� � <br />PER11111T APPLrC/aTION <br />BUILDINGI�'VIECHANICAL/PLUMB�NC/S1GN/SPRiNKLER/D�MOL�ITION <br />C1TY O� EV�RETT PERMIT SERVlCES <br />3200 Cedar St., Everett, WA 9820� - 425-257-8810 -- FAX 425-257�8857 — www.everettwa.org <br />APPLICATIONS ARE ACC�PTED FROM 8 A1V170 4 PM <br />�.. � ���...._-230 l - �S-f�� � <br />L�GAL fof new conslYucliO�' Short Plat/subdivisl0 <br />OWN�R I{� ti 1M� � <br />Address 23 D 1 -% 5' y <br />CONTRaCYOR �V�Z�����F� <br />Ada�ess 2l 2U ��-u�( C, <br />T�NAN7 BU5IN�SS NAME <br />BUILDING PERIYIIT APP�.IGATION <br />_ <br />; <br />Lol Na. <br />PhoneJE-mall <br />C1tylSla�e/Zfp <br />� IL&ILIc.# <br />� �il�-iU�_ <br />(a�(ach copy oF long Ie�81 tloscrlpllon) <br />� — � <br />�� -! �� <br />' S b ZZ-.a � <br />mai�.�P`L�S) S%_�//� _ <br />� <br />VII T <br />Pho�elE-mall �(ff %�� -��//(�/ _ <br />CONTRACT PR1C� O� WORK � a, C� �<« <br />Exisling Use of Suilding HEAT 50URC�; <br />Proposed Use o�uildin� Gas Eleclrlc� Olher <br />Building type� � Single Famlly � Duplex _Townhouse _ Nlulli-Famiiy ___. Commercial <br />Type of project: � f�ew _ Addltlon ,_ Remocivl �Re�,�ir_ T�I. ,� Sign �S�7�fnkfer,_,DemolfttonJ,Change oi Usa <br />DOSCflption of WoriC (addillor�af space proviriBd on the backJ: <br />�,�� == ��-�z L���-c� ���� <br />Have you started working without a permlt? �YES �NO <br />lV1ECHANICAL PERM�T APP�ICA7�ON <br />Ty�e oi P�aJacl: �Nevv�Adc3n `�Ileretion _�tepalr <br />Show Nunrber 1�) ol f/xfures <br />PJC - air handlfng unils <br />� FOfC6d air sY3i2R1& <br />Waler hoaler <br />Gas freplaca <br />Gas range <br />Cloihes ciryer <br />�an�e iiooc� <br />�xhaustfan <br />Heat eump <br />Unit heater <br />aoilar <br />Refrlgerafion <br />Woodstove <br />Duclin4 <br />SPRINKL�R / SIJPPRESSIO <br />Number af Hesd <br />�M <br />P�,UMBrNG PERMIT APpLICAT1oN <br />of PtoJecl: JNew_Addn _Alteration _}ze��alr <br />ShowNumber(#1 o/I!x(ures <br />asin <br />i<ilchen sfnk & disposal <br />pishwasher <br />Clolhes washer <br />Water heater <br />Slnk (seNicelbar/mop/e <br />Backl1ow preVenter <br />Urin�1 <br />drinkfnc� Founiain <br />Floor draln <br />Grease lra� <br />Roof dralns <br />Medlcal Gas <br />Olher._ <br />I hereby caYli(y Ihat I have read �nd examined lhis applicallon and knotiv lhe saTne lo be irue and correol. A�I provlslons of larrs end ordlnances governfng <br />lhls type ot worK �vill be complled �f�ifh �s er specified hefein or not, ihe granUng a18 p�rmlt does nol pfesume (o glve aulhorily !o Vio(ele o� eancel <br />lP�e prov(sl .n of ny olhe� sfal ofl cal la regula[fnp conslruolion or lhe performance of cohslfucilon. Thal I am aulhorized dy lha o�vner of (his property <br />lo perfor �he vrk for whi appllcallo s med end I comply wilh lhe Slete Conlractors Law 18.27 RGW and 296.200 WAC <br />�� � -�`�=1 <br />Ov�ner/A ihvrizad Agen a e Dale � {Revlsed 12/2090) <br />