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12/30/2015 WED 12: 30 FAX Fast water Heater l004/004 <br /> PERMIT APPLICATI <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLI I N <br /> CITY OF EVERETT PERMIT SERVICES 11 D <br /> 3200 Cedar St., Everett, WA 98201 425-257-88W FAX 425-257-8857 www.everettwa.org <br /> SIT ADORES': �� P•OP TAX il/�9�Q P R IT# <br /> `tea► ��3 1w1l tJtJ"IrD I(�(� . , i {�U�"Ii� 'O�� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> -w <br /> OWNER ' ' p ellA Phone/E-mall 31 L4 12--- 69-43L1 <br /> Address ST 12;1}k AV V \id 3 b i City/State/Zip L I ` kA)P' °l Vl gab 3 <br /> APPLICANT; Owner Owner's Agent Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do Mork In the space) <br /> • <br /> CONTRACTOR A W�' I � Nr'e` �4' ' <br /> ' State Lic.# M1 V W kiCri 4` City Bus. Lfc. 5?; <br /> Address ( � I N •E, PVuk-I moi I�'V. D( ( <br /> ,a� •, � •Y, Phone/Email �.�� �,3 ,, it h?+ �i� a 'i +e- <br /> 1 • IT :U3INESS NAME CONTACT FOR PERMIT Tri.-I•e-r. A <br /> — A"-Ni VE- <br /> — Phone/E—mail [s. a (► t/. 1 t .r .1 (/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of BuildingHEAT SOURCE: <br /> 1`C <br /> Proposed Use of Building S Ges.. ElectricOther <br /> Building type: Single Family Duplex Townhous: (► Commercial e <br /> T •e of ro'ect: New Addition Remodel ilaVitliy T.I. Sl.n S•rinkler Demolition Chan_e of Use <br /> DESCRIPTION OF WORK(addlUonel specs provided on the back): <br /> deltfAm 4Y. la cQ eI_ec_-_'_ wCx.l-ear Ilao- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Adcln „Alteration R.•air Type of Protect: New_Addn _Alteration Repair <br /> Show Number(#)of fixtures __ Show Number(#)of fixtures <br /> A/C—air handling • s Toilet <br /> Forced air syste• - Bathtub <br /> Gas piping <br /> Water he; -r - Lavatory(wash basin) <br /> Shower <br /> Gas fir-•lace Kitchen sink&disposal <br /> Ga. =nye _ Dishwasher <br /> •thes dryer Clothes washer <br /> -ange hood _ k Water heater <br /> Exhaust fan Sink(service/bar/mop/etc) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woadstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas _ <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> I Number of Heads Other: <br /> I hereby certify that I have reed end examined(hie application and know the same to be true and correct.AU provisions of laws end ordination governing dile type of work wilt be cornp <br /> with whether epeclped herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other slate or local law regulating construction <br /> Thal I urn authorized by th 4(LtA <br /> r of this property to perform the work for which application fs made and I comply with the State Contractors Law 18.27 ROW and 298.200A WAC. <br /> 4111ii RA <br /> O 'u hortzsd Ageenature ,2-/ Data <br /> (Revised 4/2015) <br />