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NOV/22/2016/TUE 02: 21 PM GrecpwQod Heating FAX No, 206 4" 6216 P. 001/002 <br /> uAkk Y-ICA_l.tki k_ kms{ ' __1 iI I Ind ` <br /> 2,0(Q)L*.r) --( ` .5 PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, WA 98201 425-2578810 FAX 425-257-8857 www.everettwa.org <br /> .5/5 APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX U tiltIr�a r I (2 02_3 <br /> Rske) t'Ave�SE C-vex ik1J A (-1S O s W-162.9c ?nco - t '-O <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER \X B TOt.AS \A Phone/E-mail C�3,01)-103 — 1C ., <br /> OVA Address S [b. Y1�jAvQ., Se- City/State/Zip e v..)4-a+t WA- G,Ba,.eK <br /> APPLICANT: Owner Owner's Agent 1 Contractor Contractor's Agent Tenant(must provide a letter of canaent from tie owner to do work io the,Paco) <br /> 1 1 <br /> CONTRACTOR CT( -w �\ GAC�q A AC_ L&I Lic.# C�e E� if 1�2.„3 \ COEB�uuss. Lic.#( 'I�jQ85. <br /> Address 82$ S S k c " S I Se k-lk i jA IP- ( (3"Iu Phone/Email c3 )ZFLI --[ ' l <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 4R0( E'G \._. Cvee)a 6i-1 A-C_ <br /> Phone/E-mail baai list-t--t. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0 r)0 <br /> Existing Use of Building - HEAT SOURCE: <br /> Proposed Use of Building Qasy Electric Other <br /> Building type: \k Single Family Duplex Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sign Sprinkler Demolition Cl-ange of Use <br /> DESCRIPTION bF WORK(additional space provided on the hack):p V�1 i <br /> WR- Gycl(S rt\cks e. , htnbx C L-1-%O v l-F C?G 36 3 alb <br /> ` v,s,k,A,1 wotker hcovIvr, S't .fie \)12.(050—ev-- . cx .1 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type Of Project: New Adds _Alteration_Repair <br /> ' <br /> Type of Project: New_Addn Alteration_Repair <br /> h w Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub -r <br /> Gas piping Lavatory(wash bash) <br /> (.1_} Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> . Gas range Dishwasher <br /> Clothes dryer_ Clothes washer <br /> Range hood Water heater <br /> 0 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 /> Number of Heads Other: <br /> I herety certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be compiled <br /> with whether specified herein or not.The granting of a permit doea 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 applloation Is made and I comply with the State Contractors Law 18.27 RCN and 296.200A WAC. <br /> 111 a1cQ <br /> Own /Authorized Agent Signature Date (Revised 6/2012) <br />