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01/06/2016 WED 10: 35 FAX Fast Water Heater U1003/003 <br /> I+IPPRMIT APPLICATI I <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES q° 1 A ? <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettvva.org <br /> SITE ADDRPRO ` ' <br /> SS; PROPERTY TAX# M T# r <br /> i►. , 1. A. , sol -vers ° bLi o rb" . a i b / i —/22 <br /> LEGAL for new construction: Short. I <br /> P,lat/subdlvlsion Lot No. (attach copy of long legal description) <br /> OWNER -J I NI hNST e. Phone/E-mail 06 -3 / 35-5? <br /> Address 10( 59/A9/AA-IL Clty/State/Zip G v � w <br /> fi7--/ 9- 9.85-2,611APPLICANT:_Owner Owner's Agent Contractor Contractor's Agent _Tenant(met provide a!attar of consent from the owner la do work In the apace) <br /> CONTRACTOR r /ST . 4 -g- -A- State tic.# FAs rW Wg' City Bus.Lic.#5-0-45-S <br /> SP I <br /> Address 01"15. e-E,E-K. `t'(� vul,l C rjb*IAIHQ W A- I Phone/Email OS.(yj7 , (i, r• WI i-175`�^7�l$tT.•-ia-+ <br /> TENANT BUSINE -JAM E CONTACT FOR PERMIT IA/a-( .gA-N1 +V' <br /> Phone/E-mail . al . .• 0. a. ' _ <br /> I I,_�...rl. i 1' i'A.+/ ' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK i 6 (..co, <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building -� S <br /> I� Go Electric Other • <br /> Building type: _Single Family —Duplex_Townh. : _1 ulti-Farli Commercial <br /> Type of project: New Addition Remo.-I ► Resell' T.I. Sign Sprinkler _ Demolition Change of Use <br /> DESCRIPTION OP WORK(additional space provided o7) <br /> ¶ tw o 4 rt 1 a C=am _ S . wet 4-��-• 1A�.at�4-P�- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION - <br /> - <br /> Type of Project: _NeW_Adds _Alteration_-Repair Type of Pr• act: _New_Adds Alteration Repair <br /> Show Number(#) <br /> ).of fixtures <br /> Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas i in ilk Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fire lata Itchen sink&disp <br /> Gas range <br /> D washer <br /> Clothes dryer Clot1 =s was <br /> -. Range hood Water r <br /> Exhaust fan Sink -.: ce/bar/mop/etC.) <br /> Heat pump <br /> Unit heater Ba ow p 'venter(Inside bldg) <br /> nal <br /> Boller snaking Founts i <br /> Refrigeration <br /> Floor drain <br /> Woodetove Grease trap <br /> Ducting Roof drains <br /> Other Medica!Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads I Other: <br /> I hereby certify that I have read and examinee this applrcallon and know the same to be true and correct.All provisions or laws and ordinances governing this type of work will be comp <br /> with whether apeclned herein or not The granting of a permit does not presume to give authority to violate or cancel the provision or any other stale or local law regulating construction <br /> Thal I em authorized by IgA owner of this property to perform the work for which application Is made end I comply with the State Contractors Law 18.27 ROW end 295.200A WAC. <br /> lel1 1\*UtiL I 1✓ I P - I I n <br /> 1 -(� <br /> Ow •- ,uthorized Agent Signature Date (Revised 4/2095) <br />