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JUL/19/2016/MON 12: 24 PM North Creek hoofing FAX No, 425 4R7 Fj524 P, 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 Wn/w.everettwa_org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS, PROPERTY7AXft Van <br /> --u�. <br /> -LoOG 'l, Vl. S <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail ( - <br /> Addi8ss Lz 0 (, S^' City/State/Zip Vl"C <br /> APPLICANT._-maker Owner's Agent contractor ContraCtofs Agent _Tenant(must Drory tle a fetter of...ntf om the ownerto do vrork in qhs spec.) <br /> CONTRACTOR +V c C( tR- L_¢cr o i L&I Lic.#�O �u Q COE Bus. Llc.#.63ZSec <br /> (�Z 5,�ir—,� mob. ��-� <br /> Address � O�o vG�•� �� �f � Phons/Email uZS�' �'L �-IQ, <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 1L.1b-{ ,r-,,- <br /> PhonelE-mai( LkZ�z-'-�,% - 'C�-g (4 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ta, w-)C"\- 0- <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other <br /> Building type: Single Family —DU lex_Townhouse —Multi-Family _Commercial <br /> Type of project: _New _Addition Remodel Repair T.1. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 7.R If 0� �WNII.1 1-00i'l 1-� X o t'►�SLS vV L Y-k v �. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New,_-Addn --Alteration_Repair Type of Project: _New---Addn `Altoratlon_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> f A/C-air handling units Toilet <br /> Forced airs stems bathtub <br /> Gas Lavatory wash basin) <br /> Waterrhheater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range <br /> t Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mop/etc. <br /> Heat pump <br /> C Backflow preventer <br /> Unit heater <br /> Urinal <br /> Boller DfinkinQ Fountain <br /> Refrigeration I Floor drain <br /> Wocdstove <br /> Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other: <br /> Number of Heads Other: <br /> I hereby cariify that I have read and examined thia application and know the same to be true and cu"d,All previsions of laws and ordinances goveming this type of wom will be compbed <br /> with whether spacined herein or not.The granting of a permit does not pn;sume to give authority to violate or cancel the provision or any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC, <br /> ®rIlAuthorized Agen Igna u Data (Revised 6/20f2) <br />