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Dec 16 2016 07:33AM Washington Water Haters 8663757454 pacn <br /> PERMIT APPLICATION <br /> BUILDING MECHANICAL, PLUMBING/S1GNISPR1NKLER/DEMOLI"TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa org <br /> SITE ADDRESS/7 JPPER1Y TAX# <br /> LEGAL for new construction: short Plat/subdivision <br /> Lot No. (attacfil copy of long legal desclipiion) <br /> • <br /> OWNER i4 0 S 7l D -%5,,i 6� y� <br /> /7 � �� /�! �/ Phone/E-mail 2 171.2, 94537 <br /> Address d , rr �l e'G3 L3 UU City/State p - 0 • kffiq '0 OL <br /> APPLIGANT: Owner <br /> Owner's Agent Contractor _Contractor's Agent Tenant(must prnniideafatter ofwnscrifiern the <br /> ,..i awrer to do Muck in the <br /> �s�pa/c��) <br /> CONTRACTOR kjas ii frit 1 /V ' �✓k/ State Lc.# (r(Jj4 7 77 <br /> Address �r'''� �:` Pi -� r J ,--11.5.- j �` 'Y" t n !•:".-.,- �.EC g��1/U! City Bus. LiC-# a 5J� <br /> ' �% ^a,.lJ: i-:, '1� i/,;....1(:,,! t l.✓!%L Phone/Email 00 7l' �(� i//C <br /> TENANT BUSINESS NAMEoD kw <br /> 'CONTACTFOR PERMIT , ' if% Cl <br /> • it.)/4 <br /> Phona/E-mail V/0 L,IF' i <br /> BUILDING PERMIT APPLICATION <br /> CONTRACT PRICE OF WORK /DO <br /> AP <br /> E fisting Use of Building 5/Call <br /> HEAT SOURCE: <br /> Proposed Use of Budding <br /> Gas ectric_ Other-------, <br /> Building type_ ILSingle Family Duplex Townhouse _Multi-Family Commercial P`'--C_,,_� <br /> Type of protect New Addition Remodel Repair T.1. Sign Sprinkler_� emolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> knOV - p/a( 1 1 :9d. 44 <br /> .. (s <br /> MECHANICAL PERMIT APPLICATION <br /> PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration_Repair <br /> Type of Project: New_Addn �Alteration Repair <br /> Show Number(#)of fixtures <br /> AIC—air handling units Show Number(#)of fixtures <br /> r Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range <br /> Clothes dryer Bishwasher. <br /> Range hood Clothes washer <br /> Exhaust fan Water heater <br /> Heat pump Sink(service/bar/mop/etc.) <br /> Unit heater Backflow preventer <br /> Boiler Urinal <br /> Refrigeration Fountain , <br /> Floor drain <br /> Woodstove <br /> Ducting Grease trap <br /> Other Roof drains <br /> eth <br /> SPRINKLER /SUPPRESSION SYSTEM Other <br /> Number of Heads Other: <br /> hereby certify hat 1 have read and examined this application and know the same to be true and correct All provisions of laws and ordinances governing thry <br /> with whether specified tenet or not.The grarnng of a permit does not resume to g 9 type u wing win st camp; <br /> /tYiat 1�authorizedy the owner of thi p �'E authority to violate or cancel the provision of any other slate orbcallaw regulating construction <br /> property to ertonrr the work for which appt tea is made and I comply with the State Conk-actors Law 18.27 RCW and 296200A WAC. <br /> ) 2 -(15' 1 ( <br /> or//Authorized Agent Signature <br /> Date <br /> (Reviser!92074) <br />