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Dec 16 2016 07:37AM Washington Watel E tens 8663757454 pagl 1 <br /> z <br /> • <br /> • <br /> PERMIT AP ' ICATION . <br /> BUILDING/MECHANICAL PLUMBING/. IGN/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 /> SITE ADDRESS:/qt 1 fionia _O PROPERTY TAX# PE T(O"/ ed <br /> o0 r5000O3 Z IAT Tlp(z-ego <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal <br /> description) <br /> OWNER eep�I , nl yrfa. /f V4 Phone/E-mail �Z 6- �� 1 plo,glV( 0 9 r ��g <br /> Address ! ergeLile iec City/Stater4P 6 W /•D2 3 <br /> APPLICANT: Owner _Owners Agent —Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR k/aShingjvn gRALCV <br /> ///' eak�r5f State Lic.# Wit5/4. -J.q�IJQppCity Bus.Lie.# D&,.3' 41-11-9 <br /> O' 5Qg Remi ri wig- (gJ",/4 . _ )Phone/Emall�j00—g77 f WG�.fklitMacf�n <br /> TENAN BUS NE S NAMECONTACT FOR PERMIT J <br /> ,u/A, �etC y., l <br /> 6 Phone/E-mail 0000 5A <br /> BUILDING PERMIT APPLICATION A CONTRACT PRICE OF WORK <br /> Existing Use of Building R-2 ci cicol I HEAT SOURCE: <br /> Proposed Use of Building Gas •u� . er_____ <br /> Building type; ingle Family T,Duplex Townhouse Multi-Family _Commercial • / �_ )--- <br /> - <br /> Type of project: —New Addition Remodel Repair T.1. Sign_Sprinkler =-.._ :en Change of Use <br /> DESCRIPTION OF WORK(addition&space provided on the back): <br /> eiln a Q i 4e-elPia'a I --e /-et C711C, tots-P-e-K' -iaeK (sJ <br /> MECHANICAL PERMIT APPLICATION I PLUMBING PERMIT APPLICATION <br /> Type or Project: _New Addn _Alteration_Repeir Type or Project: New Addn Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC--air handlin. units i 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 Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood IFI Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler DrinkingFountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> i Number of Heads t Other. <br /> I hereby certify that I have reed and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp! <br /> with whether spedfled herein or not.The granting of ermit does not presume to give authority to violate or cancel the provision of any other:Meteor local law regulating construction <br /> authorized 1 owner of thi party to dorm the work forwlech application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> AO <br /> iillip <br /> • 'Authorized Agent gnature Date (Revised 9/2014) <br />