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04/15/2015 WED 10: 24 FAX Fast water Heater U002/002 <br /> 0 0 1 as s <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/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 /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADDRESS: r PROPER TAx P T . <br /> VT � > I <br /> LEGAL for now construction: Short Plalfaubdivi n Lot No. (attach copy of long legal descriptlon) <br /> OWNER p PhonelE-mail SIj 7iL, <br /> Address '91,13-'IftbIt <br /> OL V CliylSlalelZlp �'�� (� l t <br /> APPLICANT: Ownar _owner, <br /> u Agent KContractor `Contraclor'e Agem W.-Tenant(must provldo u lellerorwneem from the ow cr logo wo(k In the apace) <br /> CONTRACTOR -I' � T r!a L&I Lic,# w �j(v COE Bus. Lic.# �j <br /> Addreae l '11?g5 North creek* r'kwa outl),S1 EC-106 Bothell,WA 98011 ?mall �� �S��a ( I�en of tC V1 <br /> TENANT BU INFBS NA l /5,rN7A.CT FOR PERMIT `S `` <br /> Phone/E-melt' s <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF ORK <br /> T-- <br /> Existing Use of Building HE E: <br /> Proposed Use ofBuildingGas Flecirlc Other <br /> Building type: l/\Single Family Duplex Townhouse Multi-Famlly _Commercial7 @ of ro'eoL'` 1 New Addition Remodel Repair T.I,_Sin Sprinkler Demolition <br /> Change of Use <br /> DESCRIPTION OF WORK(addXonal spaco p(ovfdad on the back) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projoul: _Now_Acid" _Alteratlon Repair Typo of protect: „New_Addn -—Alteration Repair <br /> Show Numher(4)offlNtUrea Show Number 0 offlxtures <br /> A/C—alr handling units L Toilet <br /> Forced airs stems Bathtub <br /> Cas pipinqLavatory wash basin <br /> Water heater Shower <br /> Gas fireplace KltchOn slnk&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothas wooher <br /> Range hood Water heater <br /> Exhaust fan $Ink eelvice/bar/mo /etc. <br /> Heal Pump Backflow preventer <br /> Unit healer Urinel <br /> Boller Drinkin Fountain <br /> Refrl eratlon Floor drain <br /> Woodstove Grease trap <br /> Ductln <br /> Roof drains <br /> Other __ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads <br /> Other: <br /> I horoby cenffy Thal I have read and examined this eppllcollon and know the same to be true and correct.All provlilona or laws and ordlnancee governing thla typo of work Will bo compllud <br /> whh whether speclned herein or not,The granling of a permit done nol preaurne IQ give awhorily to vlolmo or cwncei the provlelon of any cthor alelo or local law regulating construction <br /> That.I am authorized by IhQ^owner of chis orooerly to gedorm the work for-hlch appllcation is made bnd I comply kiln the Slale Cunlrp�;Iors Law 10.27 RCW and 280,200A W.4C. <br /> AuthOYlYea hynrn.,�d�,...0 Data <br /> (Re vlsod 612012) <br /> 4 <br />