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NOV/01/2016/TUE 01 : 43 PM Greenvlood. Heating FAX No. 206 462 6216 P, 001 <br /> rtwq Ca i t circ R* fag Mem <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: <br /> l � <br /> LEGAL for flew construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER a phone/E-mail ,q 5� <br /> Address W� t"} ,� CRY/state/zip U\,1Q q.: 2-0 <br /> APPLICANT: Owner _Owner's Tenant Agent Contractor Contractor's A Grit T <br /> B ant lfL llBt UfOVld9 fl ot3or of const n[from:hc owner t0 h0 WDr 8pd�x <br /> CONTRACTOR �� �� L&I Lic,h VEEL OE Bus. Li . # <br /> Address ( sC J� (� - Phone/Email <br /> TENANT BUSINESS NAME C NTACT FOR PERMIT <br /> � � <br /> AC- <br /> 1Phone/E-maiJ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Bu[Iding_ HEAT SOURCE: <br /> Proposed Use of Building Gas v_ 1=lectric Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of ro act: New Addltlon Remodel Repair T.1, Sign <br /> Sprinkler Delnolitlon Change of use <br /> DESCRIPTION OF WORK(additional spats pfovldod on the bank): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Projoct ew Addn `Alteration_Repair Type of Project: _Nsw—Addn _Alteration Repalir <br /> Shote Numbor(#)of fixtures Show Nurtibor(#)of fixtures, <br /> A/C–air handling units Toilet <br /> Forced airs stams Bathtub <br /> Gas pipinq Lavatory(wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refri eraIlon Floor drain <br /> WOOdStt7ve Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / ,SUPPRESSION SYSTEM other' <br /> Number of Heads Other'. <br /> I hereby certify that t have read and examined this application and know the same to be true and correoU All provisions of laws and ordtnancea governing this type of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume to glue authority to violate or cancel the provision of any other state or[coal law regulating construction <br /> That I am authorized y the owner of this property to perform the work for which application is made and I complywith the State Contractors Law 16,27 RGW and 296.200A WAC. <br /> Il I I [ <br /> Owner/q horized Agent Slgnaturo Date (Rovisod 6/2012) <br />