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Jul. 19. 2012 12:40PM EVERGREE�' STATE HEAT & AC �0. 2196 P. 1 <br /> ( l <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETf PERMIT SERVICES <br /> 3200 Cedar SI., Everelt,WA 98201 425-257-8810 F'AX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE acCEPTED FROM B AM T04 PM <br /> Sli QDFjf�$� � PROVERTYTNIN PERMIi� - <br /> Vr� <br /> LEGALtornewconslruUlon: ShoAPlaVaubtllvislon Lo1No.^ (allechcopyotlonplo0��a06uSplion) <br /> OWNER �l�V� PhonaE-man p{ <br /> AddresE ,v, b� �l�V GlylSlele/Zip � <br /> APPLICANT: ONner _OaneraAgenl Conunaor ^ConireUorsApent 7anant(�uaro,u..wiuraoo-rw+aa„neoMwioww�cnv++p.al <br /> CONTRACTOR 8 I Uc.� V'Q 0�`�U COE Bus.Llc.it ��� 5 <br /> Addre�s (� � � Vp� i�.�w PhonuEmdl - �d ` � I <br /> 8 S A E CON ACT FOR PE I y�-�^„ � � <br /> /�1 ,, - � i m�� <br /> l �1.5�/\� PhonWe-mou <br /> BUILDING PERMIT 4PPLICATION CONTRACT pRICE OF WORK 1 <br /> Ettleling Use at Building � HEqT SOURC ' <br /> Pfopo9cd Use o/Buildilly Gas EkGric Olher <br /> Buildine typa: _Singla Femlly ^�uplaz_Townhouse Mu t•Family _Commerclel <br /> eof ecl: New _Addnion Remodel Repalr T.I. Si n S rinkler oemollUon_Chen e ofUsa <br /> DESCRIPTION OF WOFiK(add�tional apace pmvided m reo ba <br /> ��A,.kv.� � ��� �'��n � o�s �, P��l�.� <br /> d- �,J 1 (��acam•� <br /> MECHANICAL PERMIT 4PPI,ICATION PLUMBINO PERMIT APPLICATION <br /> TypeolProJecl: _N�w__addn �Itenllon_R�palr rypeofPreJ�ot: _New�ddn Albniton,___Repelr <br /> ShowNum6cr � o�//xrona ShowNum6er afllrl✓rci <br /> A/C-elrhandlin units Toilel <br /> FOrCCdalra stems Balhlub <br /> Gas t (n Lavalo (wash beeln) <br /> Weler hoatef ShOWBr <br /> Gas fire lace Kitchen slnk�dis osal <br /> Gas range Dlshwasher <br /> Clothes dryer Clolhes washar <br /> Ran�e hood Water healor <br /> E�ewl len Sink cervicelbar/mop/elc.) <br /> Heatpum 6ackflow revenler <br /> Unit heatar Udnal <br /> 9oiler prtltklny FoUntein <br /> Rafri eraUon Floordra�n <br /> woodslove Grease tre <br /> PuGin Roof dreins <br /> Olher Medlcal Gac <br /> SPRINKLER/SUPPRESSION SYSTEM Other. <br /> Number of Heads Olher: <br /> I hem6y unAy Iha1 I have ro�a aM aumincd Iliu�ppiaikn and knoW IAO eame lo be W s�rM roma.N prnHebns d ITMs�nd adYuna�goverNq IIY�ype olxakxi b�compiee <br /> xnh wfieiher�peGAeO hercin a ml.Tha pranWq W s pplmR pas n01 pwum�b pir�euNaYy to Nolete a ancal Ilr poNJm ola�y Wk!alMe a bul l�w rpu{�Wq oorolnXlbn <br /> 7�M I am aulho�ized by Ihs v.mar d iNe propdty lo peAo�m N�woile fw vAiUi apptatlon p made and I oompy wfih�he SlMO COMradore�aw 1t27 RCW uq 29�200A WAC. . <br /> C�x��� �—�'nlY.e�� ''1 '��- 1 `��. I <br /> OwnerlAulhorlxad Aponl Sipnaturc Dale (Reviaed f✓lOf2) <br />