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FROM :Evergreen State Heat & A/ FAX NO. :4252596660 Jan. 11 2011 08:42AM P1 <br />l `//-/f <br />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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />bit <br />t2l <br />RTY <br />PE e <br />LEGAL for new construction. Short HaUsubdlvislon___ _Lot No..__ (a8ach copy of long legal desenptbn) <br />p <br />OWNER'' <br />Phontr moll 4a - 3' �� - ! <br />\\ <br />Address `A �>M VIuvynijR I Vd <br />Gry/SletafZip 1k)A a <br />CONTRACTOR V PY <br />L & I Lie. !to Ve 7 <br />Addreex Q PhonsfEmall <br />BUSINESS NAME <br />GUNTACTOR PERMIT <br />PhorWE-mail laVL — •a _61114 <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �l iy} UC7 <br />Existing Use of Budding 120 HEAT SOURCE: <br />Proposed Use- of Building I Gai i other <br />Building type: 4. Single Family — Duplex_Townhouse _Multl-Family _Commercial <br />Type of project: —Now _Addition _Remodel^RepiT.I.,_ Sign —Sprinkler _Demolillorihange of use <br />Description of Work (nddili0nal specs provided on Mn back). <br />t,Jcjz- r 1-7 ec.fr <br />Have you started working without a permit? -__YES )NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: flew __.,#ddn,-Altara8en_JtePalr <br />Show Number aaruro of s <br />Type of PnoJect:_Ni __lddnAltersdon—Repair <br />Show Member <br />8xarrea <br />A/C - air handling units <br />Forced air systems <br />Gee piping <br />Water heater <br />Toilet <br />Bathtub <br />Lavatory wash basin <br />Shower <br />Gas fire lace _ <br />Kitchen sink & disposal <br />Gan range <br />Clothes dryer <br />Dishwasher <br />Clothes washer <br />_ <br />Range hood _ <br />Water heater <br />Exhaust trim <br />Sink (seMcNharlmo letc ) <br />Herat pump <br />Backff prevenfer <br />Unit heater <br />_v <br />Urinal <br />Boiler _ <br />_ <br />Drinkl Fountain <br />Refd oration _ <br />I ordmla <br />wuodstuve _ <br />Grease trap <br />Uuct <br />Roof drains <br />mel <br />Or <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />I haraby cnnify that I have read and examined this eppllcalion and know Ine same to be true and correct. All provisions of laws and onllnances go"ri <br />this type of wad wit' be complied with whether spacipod hsmin or not. The griming of a permit does not presume to pine authority to violate or cancel <br />the provision of any othor state or local law regulating coarnhx:lion or the pedarmanco or construr4lon. That I am euthorlied by the owner of this prapwty <br />to porform <br />.--1..�— work for which application ismade and I comply with [he Stale CAntfettors Law 13.27 RCW and 29b100 WAC <br />l ll -11 <br />Owner/Authorized Agent Signature Dato (Revised .,Z20f0) <br />