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• <br /> Nov 06 14 08:16a Washington Water Heaters 4257461563 p.1 <br /> ' PERMIT APPLICATION <br /> BUILDING/MECHANICAL IC_LUMBING/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 p8 AM TO 4 PMPITT <br /> SITE ADDRESS:/(0(x) /a I�� i-SC 474/v0 PROPERTY <br /> X it <br /> 0 c —7 SO/331e WG *I("D 41 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of tong legal description) <br /> OWNER p`i(tJ I9'UWI phone/E-mail 1A2 --33 g^ 20/3 <br /> Address /600 / / „ J- it/iC662 .city/state/zip E;-1/..e ve6L. L(/h ciF2L <br /> APPLICANT; Owner Owner'sAgent Contractor Contractors Agent Tenant(must provide a tatter at consent from the owner to do work in the space) <br /> !, <br /> CONTRACTOR v14-5r`!'f4r•riy rGY'v /2Z-,'F:a. i7 -� �i�� <br /> ?• '7S L&I Lic.# Sr-1j f_, :�� /?(.i 0-, COEr Bus.Lic.# ✓ 3 <br /> Address f�f'lil) Ci(1 i:i2j �1. ) J I J� JQ Ile✓iJ 10/4. 'MO 5 lPhone/Email pct`.-tj%_ (`j3- ii f,v-icA /Yf1./i <br /> TENANT BUSINESS NAME <br /> kJ! CONTACT FOR PERMIT �7tL.it'C':f i'19 <br /> ,...J&CCd ,1)61.n c Z ' !- <br /> Phone/E-mail •�0_a�,V, ��s (:6;1/!L(.Lf GY <br /> BUILDING PERMIT APPLICANTCONTRACT PRICE OF WORK 1 G/ D <br /> Existing Use of Building ,4 t �J7 t.'ION vi J]al HEAT SOURCE: <br /> Proposed Use of Building Gas Electric /- Other <br /> Building type: Single Family _Duplex Townhouse 4Multi-Family Commercial <br /> Type of project: New Addition !,Remodel RepairT.L Sign Sprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New,Addn Alteration Repair Type of Project _New TAddn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—airhandlingunits . Toilet <br /> Forced air systems . Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood j Water heater <br /> Exhaust 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 /> Number of Heads • Other: 1 <br /> I hereby certify that I have read and examined this application and know the came to be true and correct.Ail provisions of laws and ordinances governing this type of work will be Complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of Ibis property to perform the work for which application is made and I comply with the Slate ContractorsLaw 18.27 RCW and 296.200A WAC. <br /> i )ei.te,t (ty datt.LL 17- 7-6._/ <br /> O riAuthorized Agent Signature Dates` [;%`7Li'I �>! -in,” �l • U./ 6 /l t` <br /> (Revised ti/1072) <br />