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Feb 26 15 07:49a Washington Water Heaters L77461563 p.1 <br /> PERMIT APPLICATION <br /> BUILDINGOVIECHANIcAPLUMBI1G/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wWw.everettwaorg <br /> 51 i E ADDRESS: n M �PRoPERSY AX#. PERMIT <br /> 00 :01.o!' 0o90 6o65a.oloo 1 ;14 l5O_� -0� <br /> LEGAL for new construction: Short APlat/subdivision Lot No. (attach copy of <br /> long legal description) 4, <br /> OWNER / 1 t ' I mo► � Phone/E-mail J 2_ b 1 Le,- scl ca,„ • <br /> Address j0(716 L6 i1 )6•to ti() 44-6.g-o 1 City/State/Le - v-C,'k-e ht GO h qD 0-/ <br /> APPLICANT: Omer _Owner'sAgent Contractor Contractor's Agent Tenant(must provide a leder of consent ham the owner tv do wodc in the 3;a al! <br /> _CONTRACTOR t r (.� 'p" ,'� '. ; r fi � _.- � ,A-/-/ <br /> I <br /> I+IfCshrief61f7'1 r(1)CLd-LY J -�r c� 1State Lic.# P.�t'•,5 -1.., 4-6/o%1 City Bus_ Lic.# o 13 i <br /> 'Address /�{Jc /IC i1i;YG(S iev1 Sk.•.- r 13 fk; £'J iu Phone)Email 'GD V4501 WO'„IA1-wij2UC? <br /> rt. f • BUSINESS NAM iCONTA(.7 FOR PERMVltT r <br /> Flo eta yet C ( �`✓ ��f r <br /> t Phone lE,mail ! <br /> Q� 5 <br /> • <br /> BLIS!OING PERMIT APPLICATION CON TRACT PRICE OF WORK ` P , r <br /> Existing Use of Building ( P .1 de..471 T cc.. HEAT SOURCE: <br /> Proposed Use of Building Gas -Iectric Other <br /> Building type: _Single Family _Duplex TownhouseIulti-Family Commercial <br /> Type of protect: New Addition Remodel Repair T.I. Sign -_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> (,urs !Ve j • <br /> - (5 <br /> 1) <br /> 0 a4.2 -71:".3&.,.., .P.,, <br /> kairl 01/k" 182-Pl6 ..." <br /> RIIECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ^New_Addn Alteration Repair Type of Project New Add Alteration Repair <br /> Show Number(1t)of fixtures Show Number(tt)of fixtures <br /> AIC-air handlin. units i Toilet <br /> Forced air systems Bathtub <br /> Gas piping • Lavatory(wash basin) - <br /> 1 Water heater • Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> • Range hood Water heater <br /> . Echaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> • Unit heater Urinal <br /> Boiler - Drinking Fountain <br /> . Refrigeration ' Floor drain <br /> Woodstove Grease trap <br /> • Ducting Roof drains <br /> Other • Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM ; Other <br /> { •• <br /> Number of Heads • Other. <br /> I hereby cert7y that I have read and examined this application and •••w the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp' <br /> with :ther specified herein or not.The granting of a permit d.: .1presume to give authority to violate or cancel the provision of any olherstate or local taw regulating construction <br /> That��a prized by the,weer of this pro /to perform th- •• for which application is made and I comply with the State Contractors Law 1827 RCW End 295200A WAC. <br /> m •ner/Authorized Agent Sig z <br /> uneju <br /> pate I`' <br /> (Revised 92014) <br />