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07/19/2016 TUE 1174$ FAX Fab[ Water Hedter �pp4/005 <br /> OERMIT' APPL.ICA7109 <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLED/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Codd-St., Everett, WA 98201 4.25-257-8810 FAX 425-257-8857 www.everattwa.org <br /> SITE Af7DFiE3 1 r PROP 7Y TAX# P RM T# <br /> w <br /> REGAL for new conatructlon: Short Plet/ouhdlvislor, Lot No._ (attach copy of long legal deacriptlon) <br /> OWNER Phone/E-moll U��S 51U <br /> Addr®ss M C L � N Jc;lty/StateYZlp <br /> APPLICANT:—Owner —Owner's Agent Contractor Contractor's Agent Tenent <br /> w (muel Pravlde a lery@r of consent nom the owner to do work fn INa space) <br /> CONTR IAC((TOR ST � State Llc.# WW O Clty Bus, Lic_ <br /> Address L L FV �1� �,�i(/U�t� D <br /> S Phone/Email Y� <br /> TE BUSINE NAME CONTACT FOR P�E^R�M�IT <br /> gC <br /> Phono/E-mall , urzg t <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK LAS <br /> [Proposed <br /> xisting Use of Bullding EAT 50URCE; <br /> Use of B �� Eleclrlc other <br /> ullding type: incdf®Fam _,Duplex_Townhause _Multi-Farnify Commercial a of n ect: New ,addition Remodel Re air T.I. Sin $ rinkler Demolition . Chan o of use <br /> DESCRIPTION OF WORK(addltlonal space Arovldod on the bath): <br /> Pvo c , <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration—Repair Type of Projm New—Addn _Alteration Repair <br /> Show Number of flxturos Sho umberffi of fixtures <br /> A/C—air hendlln units Tolle[ <br /> Forced airs sterns thtub <br /> Gas Piping La to wash bash <br /> Water heater Show <br /> Gas rAnfireplace <br /> Gas rane Kitchen ink&d) osal Clothes dr er Dlshw&sh <br /> Ran e hood Clothes wa or Exhaust fan Water h terSink r Iru ba mo /etc. <br /> Heat um It heater Ba ow rovente inside bld <br /> Bonal <br /> Holler ' <br /> Refrl eraffon rinklnq Fountain <br /> Woodstove Floor drain <br /> Ductin Grease'tra <br /> Other <br /> Roof drains`ZPRINKL N UPPRESSIOTEM <br /> Medlea' f Gas <br /> Other <br /> Number s Other: <br /> I herabY ctattlfy that I have rdad and examined this applleatton and gnow the same to b®true and correct.All provlqlonS <br /> ill be oomp <br /> With whether epeolfl0d herein or not,The yranling of a Permit does not presume to give authority to v)alp(e or cancel the provIblon of adnyB the state onr ing locelllawprepulellhg of work cvonstrucct on <br /> That I am authoriZad by the owner of thlg property to perform the work for which Appllcallorr Is made and I damply with(he Stale Contrectore Law 18.27 PCw and 296.200A WAC. <br /> OwrieAuth 4-Idg—ant"lgriaro _I <br /> Date (Revised 4/2015) <br />