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Mar.21. 2012 10:56AM EVERGREEN STATE HEAT & AC % 1377 F• <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Codar St., Everett, WA 08201 - 425-257-8810 — FAX 425-257-8857 — wvvw.everettwa.org <br />NS ARE ACCEPTED FROM a AM TO 4 PM <br />APPLICATIO <br />PERMIT <br />SITE AUURESS:� I P7MTY TAX <br />o3 -04C7 <br />� `T <br />(auaoh copy of long logo] description) <br />LEGAL for new cOnslrucllon: Short Plausubdlvlslon Lol Nat1 <br />l_r� <br />1� 3 Q <br />OWNER <br />Phonel&wail Y ot� <br />�P <br />CilydSlalelZlp <br />Address V <br />L R I Lic. f! •Q^r p- ---- <br />CUNTRJICTOR tW _� <br />rr11� <br />435 a 1 L <br />Address PhonolEmail <br />f_NA T BUSINESS 4AME <br />CONTACT FOR PERMIT <br />— " <br />Phonol&wail 1)N\1 W/'A <br />BUILDING PER TAP (CATION <br />CONTRACT PRICE of WORK_ Qom^ <br />HEAT SOURCE: <br />Existing Uso of Butlding _ <br />Proposed Use of �utlding • •'c Ges_ Elec nc_ Other_ <br />Butlding type: I^(Single Family_DupleX_Townhou _Multi.Famlly_Commercial <br />Typeofproject: —Now _Addltlon_Remodel Repair,_,T.I._Sign _5pdnkler_Demoliuon_ChengeolUse <br />Description of Work (addltion�alsj'ceo provided onthe back)' Q <br />�l <br />lA cfa 117 J <br />Havo you startnd working without a pnrmll7 YES LINO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />I ypo of project: Repair <br />Type ofProject: _NewJn —Alteration _Repair <br />_Now_Addn_Ntoratlon <br />Show Number N or fixtures <br />tures <br />A/C — air handling units <br />Tollol <br />Forced airs stems <br />Bathtub <br />Levalory(washbaeln <br />Gas in <br />Water healer <br />Shower <br />Gas fireplace <br />Kitchen sink N disposal <br />Gas range <br />Dtshwashor <br />Clolhosd at <br />Clolheswasher <br />Ronne hood <br />Wator heater <br />Exhaust fan <br />Sink(sere mopJelc.) <br />HeatpumpOacktow <br />reventventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinkin Founlaln <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducling <br />Roof drains <br />Other <br />Medical Gas <br />'.SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />other. <br />1 hereby arty that 1 have read and examined this application and Ixtow the same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether spedned herein or nol, The granting of a permit does not presume to gtva authority to violate or cancel <br />the provision of any other state or local low regulating construction or the performance or construction. Thal 1 am authorized by the ovmar of this property <br />to pMorm the worlefor whkh application is mode and I wmply vain the Slate Contractors Law 1e.27 RCW and 290.200 WAD <br />- a-1-1 <br />OwnaNAulhodzedAgent Sh lute Data (Revlsed2r1011) <br />