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FP.OM :Evergreen State Heat & A�" FRX N0. :4252596660 , Jun. 10 2011 09:23RM P1 <br /> � <br /> _ � � �II <br /> PERMIT APPLICATION `� �� ��•�� <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVIGES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—w,nvd.everethva.org <br /> APPLICATONS ARE ACCEp7F�FROM 8 AM 70 4 PM <br /> SITEADDRESB:� 1 � UC PROPERTY7AXM PE I7/ <br /> �o ` z <br /> LEGAL for nmv CAnGNUion: Snorf PtaVwbtlrvlsl�n _ Lot No._ (etteth top�of long 160e1 tlasGriptlonJ <br /> 1NNER . 1 I`I � I U�,,. Phona/E-mail ��p� � - � � <br /> ddro59 � 1 .� ( CAy/StBte2ip g l <br /> CONTRACTOR L 8 I Lic.fl Q '�, f <br /> dieas � L' Phonc/Em�4 � 5 'p1�.;� •311 <br /> U91NE-39 NAME ONT OR F'E <br /> O`^' ' `^" v P�onelE-meil <br /> BUILDING PlRMIT APPLICATION CONTRACT PRICE OF WORK <br /> E%islinp Use d Bullding., .._ . '1 _ , HEAT SOURCE: �j <br /> Propased Uso of B Ildlnp_, ��`��"`� Gec_ Eloclric Othor <br /> �uiltllnp typp• _�inple Femily _Duplox_Townhouse _Multl-Femily _CommerGal <br /> Type ot pro�tL• ___New _Addi6on _Remodol _Ropalr_T.I._Sign_Sprinklar_Demolillon_._Change of Uae <br /> Destrlptlnn Of lVOfk(addlfbnalspace provklxE on fhe hacF): ��D �1 _ . ._ . I <br /> �uLRXT'�9w'�I <br /> liavs you etartod worlcing wilhout n parmit4 _YE9 �NO <br /> MECHANICAL PERMIT APPLICATION pLUMBING PERMIT APPLICAflON <br /> Type ot VrpJeCt: _Now_Addn Allar�tlon_Hepalr yp�of Pro�ecl: _Hew_qddn �All�ntlon�Repalr <br /> ShowNumMr Jo//lxturoa 3howNum6er M r//IxNre� <br /> A/C—alrhantlll units TOilet <br /> FOfCCdOirs slems BalhtuU <br /> A°' ' ^ Lavat wa6h bnsin <br /> Water healBf Shower <br /> Gn9 firo locc Kltchon sir.k&tlie al <br /> G�s rnnpe DleMvasher <br /> Cbtlws tl er Cbihes washnr <br /> Rnn n ho0tl Water heater <br /> Exheuslfan SInN(sarvlce/badmo /plC. <br /> Huat um Bxkflow revantBt <br /> Unit heoter V��� <br /> Doiier Dnnkln Fountaln <br /> Refrl flretbn Flopr drein <br /> Wootlstove Greuse tre <br /> Ductin Roo1 tl��ins <br /> Other___ Medlcal Gas <br /> SPRINKLER/SUPPRESSION SY3TlM Olher. <br /> Numbnr of Hootls Other. <br /> I hernby�sNfp lhat I nAvo road and ozaminad Illle eppicatim an0 know Ine nnma to 6e true ane coRx1.NI qoviUons ol tawe antl orUinnnces govomin9 <br /> Iha I�pe al work will be[ompI1BE wdli wfiether 9ped6pd hBr61n ar no6 Thg pnntlnp of e DemU�tloas nol prosumu ta giva eulherrty�p vlo��le or tnnyl <br /> 140 provcbn o!any o{�or elnle of laal law repulalinq ppnsiru[Ilon or tho pgNom�anco al cmS�N[Oon.Thal I nm aUltlor¢ed hy�ce owner oi lnls propCRy <br /> ta pnr ym the wurk for Hlileh oppbcetion iaimn0e anU I wmpty wi�h Ihe Slate Canlrnqcrs law 18.27 RC'N antl 2516200 WAC <br /> I <br /> � -) L>-� <br /> Own�r/Aulhoh:Bd Apont 81pna1ura Da(e (ROvlSbtl7/10f7) <br />