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07/10/2013 NGD 17: 19 �AX 025 487 6524 Nortc=eek Roofinq �001/00^_ <br /> l <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVIGES <br /> 3200 Cedar St., Everelt, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> -� _ �APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � -a g�-+3 <br /> SITEADDRESS: ' ` �- ` PROPERNTA%k PE ITM <br /> _. . .. .. . . . . /J ! � <br /> LEGAL fcr new conslruction: Short PIaVSubdivislon_ Lot No._ (atlach copY of Ienq legal destnpl�cn) <br /> OWNER r' PhonelE-mail " � <br /> AdUiess 5 � GIyISIaIGZip q8ao <br /> APf�LICANT: O��iler O�meisAgCnl�� ConlrettOf C�mractorsAgent TCnOnt�m�slp:o�noamnero!mmenllrcminecxnerioaonwx�naesp�a� <br /> CONTRACTOR L&I Lic.a - COE Bus. Lic.# (� <br /> AdCress �, " � one/Email � - $ b <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �\ <br /> S�e,Y'Rc.R ee,LvJ <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICP.TION CONiRAC7 PRICE oF WORK �o D� . <br /> [xis�ing Use of Ouilding S\'f\ � HEAT SOURCE: _ <br /> Proposetl Usc of Building Gas_ Eicctdc_ Other_ <br /> Buildingtype�Singlofamily _Duplex_Townhouse _Multi-Family _Commercial <br /> T pe of pro'ecl: Nev.• Addition� Remodel Repair T I Sian Sprinkler Demolilion__Change of Use <br /> DESC RIPTIO N OF WORK(additiona�space�rovidei un Ihe backJ: <br /> �ea.c o� com�os�-�,o-(� roo�� ��c� � re�la.c_e. w��-h <br /> c.o,�n-� 051�-'�a�n roo�� noJ . No r�- c�eck . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProJocl: _Now__AtlJn _Altoratlon_Repnir TypeofProjecl: _New_Atltln _Alteration_Repair <br /> Show Num6cr(tll olOxfures Show Number(#)olllxfures <br /> 1 A/C-air handlin units I Toitel <br /> ' Forcetl air syslems I �athlub <br /> I Gas pipinq I Lavatory(wash 6asin) <br /> Water heator � Showei <br /> Gas freplace I KRchen sink&dis osal <br /> � Gas ranqe ' Dishwasher <br /> � Clolhes d er I Clolhes w2sher <br /> Range hood I Watei heater <br /> � Exhaust tan I Sink(servicelbar/mo letc. <br /> Heal pump Backflow preventer <br /> I Unit heater ' Urinal <br /> � 6oiler Drinking Fountain <br /> i Refrigeration ( Floordrain <br /> ' Woodstove I Grease Irap <br /> � Duclinq Roo(drains <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> il�,em�/<wiJyv�allliovereeEanEe>amineEthlsapDl.w4onan Anowlimsame1o0e1rueanacorteC.Allprovaiansolpwsandnr�inancesgoveminplhistypeotwe�knilbecomp'.wtl <br /> �.m nnet�er apenfie�heioin or not.Tho Bmnlmg ol o pe�mA Coes nct prosume lo give eulhoNy lo vlola�e ur cancel lhe D�oviaon ul any o0�e�stale or Ipoal law re9ulaW�conslmcu:n <br /> 11•,al I am auiho�@etl Gy I�o Jwnel ol l�is pmpoiry 10 pedoml Ilio wo�k fat H�ich appliulbn 15 maEe and l compli w�l�I�e Slale Ca��raciors Ltr.v 18.37 RC\4 anC:90 200A V:AC. <br /> �.�� � �Z_L- 13 <br /> OwnodAutlwrizod Agent Slgnawro Date (HcriscU G2012/ <br />