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0001/002 <br />04/08/2013 NON 9:16 FAX <br />PERMIT APPLICATION <br />BUILDINGil HANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vAvtv.everet va.or�� 3 <br />m !CATtnue ARE A(7r-FPTFn FROM R AM TO 4 PM !!ff <br />SITE ADDRESS: <br />Oak-, Aii <br />PROPERTY TAX <br />PFr MIT# <br />LEGAL for now mnsh.ncn: Shen Plat/sub_drvlsion <br />-[.of No _ (attach copy of long legal des:npphon) <br />J OWNER ' ` — `" <br />AtldessSao oas <br />PhcnoyE-mail 50 9 • O S <br />CRYyStale/tip `'e T LL/np <br />i <br />APPLICANT:_ O,vnet _Owners Agent _)�Contraciel _ Contractor's Agent _Tenant tnmt Ma•dcak:u+ro•w,.enuen ow croern dew*nlu,.r,w�ely <br />CONTRACTOR t► <br />LL I Licc.1# (.9.EXN HAtQ2'L�A+COE Bus Lic. # 0l <br />O <br />Address �ZS S • eSk'Dt S� R7Q- <br />1& <br />0 { 'l PnonN Email Q .� <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT 0LS%%%e faEfG'la� <br />CJ e::l ai CJfA t e67L 4� G <br />PhoneE-maJ — �, pM — <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK non <br />Existing Use of Building <br />HEAT SOURCE". <br />Proposed Use of Building __ <br />Building type. _Y- Single Family _ Duplex _Townhouse _ <br />Tye of project New Addition Remodel Repair <br />Gas._ _ Electnc Olher_ <br />Multi -Family _ Commercial <br />T.I. _ Sion Sprinkler _ Demolition Charge of Use <br />DESCRIPTION OF WORK (additional space provided on the back) <br />P,eekaC2 g0.S -�V r-r\o , <br />f4 &i>ScriE-tic1iii ) -75,00c>aTC-t <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now _Addn _Alteration _Repair <br />Show Number (01 of fixtures <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (a) of fiadntes <br />A/C - air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavato wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />i Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />_I <br />Clothes dryer <br />Clothes wash-, <br />Water healer <br />Range hood <br />Exhaust Ian <br />ISink (service/bar/mop/etc) <br />Heat pump <br />Backflow, preventer <br />1 Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />22—chng <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby codify Ihdt 1 have reed unit examined this ape"tbn and know Nit same to be free and correct AI provisions of Taws and oNmanus govemhg this type of work "I be compsed <br />with whebmf spa68ed herein or not The granting of a pared does not pdesuma to give authority to vielate or cereal the provision of any other stale or loaet lawrepulalmg eenstrudian <br />Thal I am authoazed by the or of this Property 10 Perform On, work fofwhkh aPp.C8b0n Is made and I raspy wth ore Slate Corilmdos Law 18 27 RCW and 296.200APIAC. <br />12�� y-8' -/5 <br />ner/Author ed Agent Signature irate (Revised e12012) <br />� 11 '�SM� @ zoCi 7 ku -tat ES {' C C . <br />tCQrvK <br />