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PERMIT`APPLICATION
<br /> .0101-si ,11!r.: . BUILDING I MECHANICAL/PLUMBING/SIGN 1 SPRINKLER/DEMOLITION
<br /> �v''' CITY OF:.EVERETT PERMIT"SERVICES
<br /> 3200.CEDAR STREET,EVERETT,WA 98201
<br /> .of 428.257-8810 I FAX 425.257.8857 I(E)'e -1&=,.,,,,i-,e, .ve :«, *•!...I www ve*filt* e.govlpetmlts
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<br /> NNIMIEM
<br /> PROJECT SITE ADDRESS;2601 Maple St. PaoPEa2TY TAX#29052000401900
<br /> LEGAL for new construction: Short 91V/subdivision . Lot No,.._,_., (attach copy of long legal description)
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<br /> OWNER NAME: Duane Collings TENANT NAME(if Commercial):
<br /> OWNER MAILING ADDRESS: STREET 2501 'Maple St.
<br /> CITY Everett Mit WA zip 98201
<br /> OWNER PHONE:2062276616 -
<br /> OfilfitER EMAILgincIVBcmaul.c©m
<br /> CONTRACTOR NAME:Green City.Heating&Air Conndtitk nin9
<br /> •CONTRACTOR ADDRESS: sraseT 948 industry dr
<br /> tiw tukwifla STAM M ZIP
<br /> CONTRACTOR PHONE:2062276616 1cONTRA►CTOR. iL 9rrettgi lavacaomail.cam ,
<br /> CONT99ACTOR LICENSE#(REQUIRED).greench866b2. • ?OFAllgRETLEIUSINESS LICENSE#(REQUIREO):055 '
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<br /> PRIMARY CONTACT: D:OWNER (coNTRAcToct CI OTHER(Please iy)1(atrirta
<br /> Katt •N r4mAu14 ere cityhvacegrnaii;cam
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<br /> �r �.-ate sF.. «°..'b y .:.Ei: _p � "Vc ��- .rt.6"51\'' x'+`p.�'•"c
<br /> •M,-= ' • Use of B ii ,!: G. “ -ct Price of Work:t•1087&00
<br /> "IFKA36006040italWIK Heat Source fliGee °Electric ©Other .
<br /> 'Standing Type: e9SFR-DeIctttd Q$PR.Attaphed DDuplex ©Multi-f=amily-#of Unris: °Commercial °Inelustrial
<br /> Project, ONety atalgithr 1Rernt del DRepeiir ©T.I. ©Sign ©Sprinkler ©Demorrtion °Change of Use
<br /> IIA'AGN Oit.WORK:
<br /> Install- boiler
<br /> ASSOCIATED BUILDING.PERMIT'Irf(if applicable): _
<br /> . i:.""77'.� `s j�: ss, .c �., v 4.,,...,v,7,...1 =V1.4 *'''''..4.1,-, ca:?>•,,,' 1.4.
<br /> Type of Project: _New Arkin _Alteration : Repel; Typa•of Pr+c eet:._..New _Aldan _Afbenrtion ,,__Repelr
<br /> of kof
<br /> List of Fixtures #of List of Fixtures . o! tsof Fixtures ;
<br /> WaList of Fixtures
<br /> Fixtures Fixtures Fixtures Fixtures
<br /> r •'. Air Handling Units Heat Toilet N ditto low Preventer.(Inside Bldg) .
<br /> Forced Air Systems • Unit Bathtub'- ,. Unset
<br /> Gas Piping Boilest :.N ( ip} t r tinRung Fountain
<br /> -•
<br /> Water Heater R ration • `J,.* Floorbrain
<br /> f RM.ace Wood :' " iT. . Sink&Disposal' Grease Trap. .
<br /> 4x,•41!'":.,- .•- . • . •moi• g e'.ip:hrvaster Roof Drains
<br /> Clotttes.`Diver Hookups Olt®r .thea Washer Medical ttas
<br /> Range Hood Water Heater Other.
<br /> Exhaust Fen • Sink(Service/Bar/MRop/etc.L Other,
<br /> Num.= •• . -ads ",.
<br /> ACKN©WLEDCEMFNT Maya reviewed this application and conTh'rt the informatRn+:contained tEtl,ai,is true and co:rect,:Work done pursuant to this pe fnit must comply' with
<br /> current Were!,state,and loCat law.The granting of a permit only authorizes approved work end no deviations therefrom.Deviations must test be authorized.in writing nom the
<br /> Building O117cfet before being authorized under any circumstances 111n the owner,ori am authorized by the owner arta property to perform the work for which eppllcatfon is made,
<br /> and I corepiy with the State Contractors Law 40.27 RCW and 296,200A.WAC.
<br /> City of Everett Official Use Only
<br /> Katrina Simonson p� ( —OS'i
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<br /> OwnoriAuthortzed Agent Signature Date (Revised 9x2 016)
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