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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 />Aeoi rrn7 OHS nor ACr.PPTF❑ FROM R AM TO 4 PM //✓ / / — / / <br />SITE ADDRESS: <br />PROPERTYTA%# <br />RMIT# _b CJ✓ <br />" \ e. <br />LEGAL for new construction Shon Plallsubd v,slen Lot No_ (attach copy of long legal description) <br />-I - - 5 y <br />OWNER <br />Phone/E-mail <br />Address V <br />City/State/Zip <br />CONTRACTOR North Creek Roofing, Inc <br />LSILic.# 901,768-00 <br />Ado.ess 17624 15th Ave SE 4105A, Bothell 98012 Phone/Emal 425-483-7986 <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />John Frazier 206-391-0476 <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACTPP.ICEOFWORK �ai� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building- Gas_ Electnc Other_ <br />Building type: X Single Family _Duplex _Townhouse —Multi-Family _Commercial <br />Type of project _Addition _Remodel _Repair _ T.I. _Sign _Sprinkler —Demolition—Change of Use <br />_New <br />Description of Work (additional space provided on the back): -' ear D �k� S-h c oc i, ,I, <br />r r <br />reF\ace �� Co���,�� Lin rood ;n5 r lad. <br />X NO rC`' / <br />Have you started working without a permit? _YES <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Typeol Project: _New_Addn _Alteration_Repair <br />Show Number (#) of fixtures <br />Show Number Pt) or fixtures <br />AIC - air handling units <br />I <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas tneing <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kdchen sink 8 disposal <br />Gas ran a <br />Dishwasher <br />Clothesd er <br />Clotheswasher <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (servicemar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />DrinkingFountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />DuctinI <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER/ -SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby 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 <br />this type o' wark will be complied wth whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perform the work for which application is made and I ccniply with the State Contractors Law 18.27 RCW and 296,200 WAC <br />Owner Aut oozed Agent signature naturee 1 \ -qDJ� <br />(Revised 212011) <br />