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OCT/20/2016/THU 09: 21 AM North Creek Roofing FAX No, 425 487 6524 F. 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 <br /> SITE ADDRESS vo 1 , F4.11 „dbJU IPROPER1YTAX# <br /> pat (` y© /� lV J_ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of tong toga]description) <br /> OWNER �1r �1 4 VLI k-ro`�c�_ Phone/E-mail [�j -- — �.p <br /> y/ -k —1 <br /> Address OC101U 1��r ju4- City/State/Zip <br /> ��tr,� 1 }4 � zo1 <br /> .. <br /> APPLICANT: Owner _Owner's Agent Contractor _Contractor's Agent Tenant(must provide a latter of con eentfrom the owner to do work in the speeoa) <br /> CONTRACTOR 6( to .._ 1 i ' L&I Lic.# Cl. O 19' -00 COE Bus. Lic_#',0-57:59 I <br /> Address 1 t(MO ,�I� +U * Ko.v �C Phone/Email lin"4 $ 6 <br /> TENANT BUSINESS NAMECON A FOR PERMIT ` <br /> 1(�s,e..(t ilc <br /> Phone/E-mail I-VLS, Li e 3---1-42t y <br /> BUILDING PERMIT APPLICATION W CONTRACT PRICE of WORK 1 eck i-1---t --62. 4 0 <br /> Existing Use of BuildingHEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: Single Family Du.1- Mouse _Multi-Family Commercial <br /> T •a of.ro.act: _ New AddiA Remodel Re•alr T.I. Sign S•rinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(e. lona(space provided. the back): O(.).--t. <br /> i <br /> 'Ca lc a. A L.03, `01-VSs-) NNIA-1 a - �t�- c .s l� <br /> MECHANICAL P - •• • -PLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn __Alteration _Repair Type of Project: _New_Addn _Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> I A/C—air handling units I Toilet <br /> Forced air systems ( <br /> Gas piping <br /> Bathtub <br /> i.- Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range J 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 J Drinking Fountain <br /> Refrigeration Floor drain <br /> ;t J Woodstove Grease trap <br /> J Ducting Roof drains <br /> Other f Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> I Number of Heads Other: <br /> I hereby certify that I have read and exemined this application and know the eame to be true end correct.All provisions of laws and ordinances governing this type of work will be compted <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 outer state or local law regulating construction <br /> mat 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 16.27 ROW and 296.200A WAG. <br /> o • eriAuthorized Age ignature Data (Revised 5/2012) <br />