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APR/27/2016/WED 11 : 16 AM North Creek Roofing FAX No, 425 487 6524 P. 002 <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 4 PM /�J� <br /> SITE ADDRESS:—�yac `)f `\,1e, €V�_VQ- -i l� PROPERTY TAX t! PEFti J 9i11t:� <br /> LEGAL for new Construction: Short Piet/subdivision Lot No. (attach copy of long legal description)i�il <br /> OWNER 2)\ c 00-1X Phone/E-mail 1 — � S---,3.- <br /> Address <br /> 1 3Address 7_ 0\ , C6Y-\ o"- -- City/State/Zip ErA1,Q,tckVIK Q Z <br /> APPLICANT:_Owner _Owner's Agent \Contfactor _Contractor's Agent Tenant(must provides letter of wneent from the owner to do work In the apace) <br /> CONTRACTOR •�\ ♦ A I I . \-2-- CA 1 L&I Lic.#4' C' GSj 9—6 8 -61 COE Bus.Lic.#',43 - i I <br /> Address \j ��U &\ lid V&- (('L t I Ij p AL- jPhOnefE=mait 75,-----(---1. Kt <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail (Lk—,, a g 3 — (a <br /> J <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ES -7_1---y 0 Z. <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other_ <br /> Building type: Y\Single Family Dulex_Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.I._Sign ,Sprinkler Demolition Change of Use <br /> DCRIPTION OF WORK(additional space mulcted on the beck): CO P-�� Ct J <br /> C1 '� sell ` I -1:����W (z Y <br /> \RSA 1 LUVvky cA t� l c..' <br /> �� Q� <br /> n01411/N V I ;D1212,0\In . <br /> MECHANICAL PERMIT APPLICATION PLUMBNG PERMIT APPLICATION <br /> Type of Project: _New_Addtl _Alteration_Repair Type of Project: _New_Addn _Alteration Repair <br /> Show Number(5)of fixtures Show Number(f;)of fixtures <br /> A/C--air handling units i 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 /> L_._ Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration I Floor drain <br /> a 1 Woodstove I Grease trap <br /> Ducting _, Roof drains <br /> Other MIIIIIIIMIMedical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads I _ Other: <br /> I hereby certify that I have read and examined tits application and know the same to be true end coned.All provisions of laws and ordinances governing this brpe 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 properly to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 256.200A WAC. <br /> iiiiii 01-1)i tl 7C) t 1,' ' <br /> "or-Owner/Authorize Agent Signature - Date (Rev/sec/5/2012) <br /> Z <br />