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0512312011 12:53 BEL-RED HEATING & AIR COND. (FAX)4254935354 P.001/002 <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 />r ATMNS ARE ACCFPTFn FROM R AM TO 4 PM <br />SITE ADDRESS: PROPERTY <br />qWV l U l U <br />TAX a <br />oa o 0o <br />PERMIT a <br />em I— _ <br />LEGAL for newconsimclion'. Short Plausubdivislon Lot Nr._ (altach copy of long legal doscdpbon) <br />OWNER <br />Phone/E-moil <br />�piJr'.r7 -Ci <br />(� /� <br />Address tl'O b, lama City/Stale/Zip <br />Q- <br />CONTRACTOR rt d ti L// <br />I Lic. R EL F_ <br />1 /�A <br />Address (yam 3 �{� t_ W Mt U O CA <br />Phone/Emoll ,� 3� S353 <br />TENANT BUSINESS NAME CONTACT <br />FOR PERMIT <br />M <br />6"'o ���-`' <br />� <br />PhonelE <br />mall c"'r . •J <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK CI (�ObeU <br />Existing Use of Building t - HEAT SOURCE: <br />Proposed Use of BuildingOz I r OUf M 2- Gas Electric Y' Other_ <br />�11 <br />Building type: ZSingle Family _ Duplex —Townhouse _Multi -Family _Commercial <br />Type of project: _New _Addition _Remodel _ Repair _T.I._ Sign _Sprinkler _Demolition_ Change of Use <br />Description Work (add4ional space provided on the back): <br />1of <br />p <br />�'plo�Ca f�G`�l�"5 I�Lv +�1QrGw�at t. l%1c� Vl9i OLI.IUP S)gCII11 <br />Have you started working without a permit? _YESi�NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _Now,_Addn _Alteratlon_Repalr <br />Typo of Project: _Now_Addn _Atterallon _Repair <br />Show Number (a) of futures <br />Show Number (N) of futures <br />I <br />A/C - air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />I <br />Gas piping <br />Lavatory wash basin <br />Water healer <br />Shower <br />I Gas fireplace <br />Kitchen sink & disposal <br />I Gas ran a <br />Dishwasher <br />Clothes d er <br />Clothes washer <br />Range hood <br />Water healer <br />Exhaust fan <br />I Slnk(service/bar/mop/etc.) <br />Bdckllow prevenlar <br />I Heal um <br />Unit healer <br />I Urinal _ <br />_ <br />Boiler <br />Drinking Foun:aln <br />Rerri eration <br />Floor drain <br />Woodslove <br />Grease trap <br />I Ducling <br />Roof drains <br />Other_ _ <br />( Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby codify that I have road and examined this applk:al'on and know lho some to be two and correct. All provisions of Iowa and ordinances govern.,g <br />this 1 e of k will be complied with whether specified herein or not. The granting of a permit does nor presume to give outhonly to violate or cancel <br />pro ro i I o other stole or local low regulating construction or the pedonnance of construction. That I am authorized by the owner of this property <br />YP <br />lode a 1 e jar wlilch application Is mode and I comply with the Stale Contractors Law 1e,77 RCW and 295.200 WAC <br />O ntnAl�)ti//q9}uo ?gent gnature O to (Revised 2,2011) <br />