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May, 25. 2016 3:46PM EVERGREEN STATE HEAT & AC No. 7128 P. 1 <br /> 111RIVIIT APPLIC ATION— <br /> BUILDIIIT KATIONAL/PLUMBaN5eKQGNaSCOuNKLER/DEOLMONI <br /> CITY OF EVERETT PERIil1IT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www,everettwa.org <br /> SITE ADDRESS: PROPERTY TA)(# # <br /> PERMIT <br /> 1 LEGAL for new construction; Short Plat/subdivisiorl_,.=:—.=..,.=:—.=.. _ bat No. (attach copy of long legal description) <br /> Z-61 i OWNER U. -1...) Phona/E-mall 'U) 2 r 9' , <br /> Addreae 0_ RI-1M.-21Z_ 1 !-' City/Stale/Zip -1 A -al • • ZAC _ ---. <br /> APPLICANT: _Owner .Owner's Agept ontractor Conlrectol'eAgent _Tenant(must provide aleiter of anssnlfrom waovnerto[IQ work inwespece) <br /> CONTRACTOR &ICRC 2 45(0 64:fri (leA 1 State LIa# 4 - OZ CIL Bus.Llo.#tX> Sr <br /> . 25Z-3 I i' <br /> Address 2.12X) 4 -`C(� _ Pho ee/Emall —• <br /> 'TENANT DUSi ESS NAME CONTACT FOR PERMIT <br /> let~N 5Aw (Lbz5--J z6i.3W 1' <br /> - _ Phone/imatl <br /> • BUILDING ILDI PERMIT) APPLICATION CONTRACT PRICE OF WORK .0.'AI• _ — <br /> Existing Use of Btillding Ht=ATSOURCE: - <br /> Proposed Use of BuildingGas V, Electric r Othe - <br /> Building type: le Single Family _Duplex Townhouse_Multi-Family _Commercial <br /> Type o project: New _Addition _Remodel•_Re.air _T i.___•sign_S•rinkler lJernolltio Change of Use <br /> DESCRIIP'l ON 05 WORK(additions!apace provided on the beck): <br /> 1 CHA6 ACAS,PERMIT APPLICATION i PLUMBING PERMIT APpLI«ATIi' <br /> Type of Project; __)JawAddn Alteration__Repair Type ofProfeetiNew_.. Addn _Alteration_ Repair <br /> Show(lumber(tt)of fixtures - Show Number(#)of?Mures <br /> IIIIIIII NC-air handling units I ' Toilet , <br /> Forced air systems 1 Bathtub <br /> Gas piping , 1 Lavatory(wash basin) , <br /> Water heater • ( Shower <br /> Gas fire.lace Kitchen sink&disposal - <br /> L Gas range Dishwasher <br /> 1 Clothes dryer - _ Clothes washer <br /> Range hood - Water heater <br /> Exhaust fan • Sink(service/bar/mop/etc. <br /> Heat pump Backflow preventei • <br /> Unit heater j Urinal , <br /> Boiler Drinking Fountain <br /> Refrl•enation ] Floor drain • <br /> Woodstove � Grease trap <br /> Ductin.• w Roof drains <br /> Other Medical Gas <br /> 7 ltiPRllNi tLIE (SUPPRESSIO SYS 1T[I~L'I/ Other: _ <br /> — - - - Number of Meads Other: . <br /> I hereby oentry ling i have read and examined this application end know the same to betrue and carred,All provisions of fawn end ordinances governing this type of work wilt be compiled <br /> with whether apeciiled he era or not The granting ors permit does not presume tagiva authority to violate or eencot the pmvlafon orany other slate or total law regulating cone rrudloh <br /> Thal I em author! d by a mar of this prop o p orris the via rk rorvfi[ch application le made and!comply With the State Conlfsctore Lew 99.27 ROW end 29s,zo0A WAC. <br /> 4/ M 16c6 07-8; <br /> Owner/Authorized Agent Signature Date (Revised 312013) <br />