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08/la/2012 10:19 4257851313 SCION REALTY GRnVP PAGE 02/03 <br /> �PER�VIIT APPLICATION <br /> BUILDING/MECHANI�AL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3�00 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 � —J� `-I� <br /> SITEADD���:919thAveSE #A EVERETT PROPEFiTYTAI(It PERMIi# Q_ ��I <br /> � <br /> LEGAL Wi new constmclion: tlhorl Platlsubtlivision Lot No._ (atlach copy of long legal descnp6on) <br /> OWNER �iz Dorri Phone/E-mail 425-337-2137 <br /> nac«55 1305 137th St Sc Cily�Slate/Zp Mill Creek WA 98012 <br /> CONTRACTOR Danika Plur.ibin & Contractin L&I Lic. # DANIKPC916LQ <br /> aa�,��ss 3614 73rd Dr NE, Marysville, WA 98270 Phc�elEmail(425)335-3515/info@danikaco.com <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �IZ DOffl <br /> Phon elE-ma:l 4 25-3 37-2137 <br /> BUILDING PERMIT APPLICATIO�1 CONTRACT PRICE OF WORK SO � <br /> Exisliny Use of Building_ ___ HFAT SOURCE' <br /> Proposed Use of Builtling Gas_ Eiectnc_ otner__ <br /> Building typr.: �Single Family _Dcplex_iownhouse _Multi-Family _Comn�arcial <br /> Type of projecC _New _4dAilion _Remodel _Ropair_T.I._Sign_Sprinkler_Demolition_Change vf Use <br /> OescriptionofWork ddrtion �spacepro��dedont�hejme ): ) <br /> �e,��e � G�� ��� .� �,�S'M ,/�. <br /> Havc you started working withuut a permitl �(_YES _NO <br /> MECHANICAL PERMIT AP4�LICATION PLUMBING PERMIT APPLICATION <br /> Typo of Projoct: _Nuw_Addn _Alturation_Rupair Typo of Project: _Now_Addn _Altcration�(Repair <br /> ShowNumber(N)o(/ixtures ShowNumbe�(X)o/lixfures _ <br /> A/C–air handling units � Toilet <br /> Forced air systems Batht�b <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shov�er <br /> Gas fire lar.e Kitchen sin!c&disposal <br /> Gas range D�shwasher <br /> CloUies dryer � Clothes e+asher � <br /> Ran e hood Waten c�aler <br /> Fxhaust(an Sink(service/badmop/etcJ <br /> Heat purnp Backflow reventer � <br /> Unit heater Urinal <br /> ' aoiler Drinking Fountain <br /> Refrigeretion Floor drain <br /> �' Woodstove � Grease Irap <br /> ' Dudin Roof drains <br /> Oiher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Olher: <br /> Num6er of Heads Other. <br /> I heieby certAy Ihal I have,reatl and ozammed this applicalion antl know Ihe same to be tme and correcl All pmvisiors of laws antl orUinances yoveming <br /> Rus type of work wril be complied with whether spucilieJ herein or not.The gran8ng of a perRit d�es ool pruswne to givu authoriry lo viol;��e or cancei <br /> lhe provision of any cmer state o�local law regWating constmction or the pertormance ol consWction.That I am amhonzed by the ovmer o(Ih��s propniiy <br /> to pertonn Ihe werk di v:hmh applicaLon is madc and I comply wi�h Ihe Slate Comractors Law 1827 RCW and'.96.2C0 WAC <br /> � �� �� _� <br /> Owna uthorized Agont Sipnature ate (Revised'7J2071) <br />