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APR/02/2018/MON 01 ; 40 PM Nor�l� Cree� Aoofing FAX No, 425 6524 P, 002/002 <br /> I'�RMlT APPLICAT�QN . <br /> BU�L,DING/MECHANIGAL/P�.U11IlB11�G/SIGNISPRINKLER�DEMOL1TtON <br /> ClTY O� �1l�R�ETT PERMtT SERVlC�$ <br /> 3200 Cedar St., �verett,WA 9820� 425-257�68�p FAX 425-257-8567 wUnN.everettwa.org <br /> AP?LICATfONS Af�E ACC�PT�D FROl4t 8 AM TO 4 PM <br /> Si7E ADDRESS:513� ��� ��. PROPERiYTAX# � <br /> � <br /> 1-�GAL for new consvuccion: Shott PfaUsubdivlsPon Lot tJo. (attach copy af long]egal descriptionj <br /> OWNER Se] Phone/E-mail ��¢—��p—���� <br /> Addres9 J \�� �.7��� 5�• Cily/SEake2ip �1Q.�� � ���Qj 3 <br /> APPLICANT: Owner _dwnet'S Agent Conb�dCto� `Contr'�CtOrs Agent _Ter�ant(must provf0e a IeGeraf conaent 6rom the owner to da wortc frt�ne space) <br /> CON�RACTOR � < �I�..Q. L&! Lic.#�Q� C, �'�(.�.7C0�8us.Lic.#��3Zc��( � <br /> AdtlP�ss j �O ��� C��p-�� .���j ���Cd�,p�t-,.���C. Phone/EmBil�Z J `�9� � `1 -��' <br /> TENANT BUSIN�SS NAM� CONTAC7�OR PERMI� i����� <br /> l /_ <br /> PhonelE-maif �ZJ 'T7j�'� ��V� <br /> �UILp�NG P�RNI�TAPPLICATION GONTRqCTPE2fCEOFWORK�_��,�. " <br /> E�dsting Use of Building HFAT SOl1RC�: <br /> Proposed Usa of ilding Gas �leccrfc Ofher <br /> Building iype: �i�lgle Farni(y _Dup[ex_Townhouse _,,,Muiti-Fam�ly _Commercial <br /> T e of ro'ect New iaddition �einadel Re air_7.{. Si n s rinkfer Demolition Chanqs of�Sg <br /> DESC%R1PTi0N O�WORK(addifional space provicled orr ths back): <br /> �Q,'If.�( � L��( �������..b'��tti9.9. �1V--t� ��w-.,�, �c��'�"� <br /> M'�CHAiV�CaL PERINiT,A�P�[C,ATIDN PL.UMSlNG PERMIT APPL�CATtpN <br /> Type of Froject: _New Addn Alferation_Repajr Type oF Projecf: _New��qddn Altaradon_Repair <br /> ShowNumbsr of!`Ixtures ShowNumber(#)ofFxtures <br /> A/C—air hflndlinq units � Toilet <br /> , Farced air s stems Battttub <br /> ( Gas piping � Lavato wash pasin) <br /> I Water heater Shower <br /> � Gas fre lace J Kitchen sink&disposal <br /> Gas range � pishwasher <br /> Clothes dryer GlothOs washer <br /> � Ranqe hood � Water heater <br /> EXhat�St fan � 5ink secvicelharimo /etC. <br /> fieak um <br /> Unit heater ) BackFlow preventer <br /> I Urinat <br /> � Boiler Drinkinq Foontain <br /> � F7efri eration Flaor drain <br /> � Woodstove <br /> { Ductin � Greasa tra <br /> Other � Roof drains <br /> � � Niadical Gas <br /> SPRINKR,�R / SUpPR�SSION SYSTEM ( Other: <br /> E ' fYumber of Heads �ther: <br /> I h=taby cs�tify that i havs rsad and examined this aoD���a�and know the same to be true antl correcP.�AI1 prvv;sions of laws and ortlinances gavamfng Ihis type oE woric w�l!bs�omp�ied <br /> with whsG'asr svec+fisd hsrsin ornot.'th^grsnGnp aF a Dsrtrit doos not ptasume to gtve aulhof,ty(o violatd or rancel the piovision oP any olheratata or focal iaw�gulating conskrvclion <br /> mat I am authv+4c�d by tfie owne�oF��s proper(y ta Dsrfonn the work forwhich appltcstfan is made 0nd I compry vdf��he Stata ConRactora Law l8.27 RCW and 29g.2ooA WA�, <br /> C.�-�. OZ_t � <br /> Ovyc� r/Authorized Aqent SiqnaEure Oate (rZsvised G/�Ql2) <br />