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04/29/2016 FRz 9:11 FAx Fa�t water xeater f�002/002 <br />-.. �ERMIT API�L�CA�`I�t� i � � �� -� -�-- <br />BUILDINC/ME�H�NICAL/PLUMBING/SIGN/SPt�INKLER/DEMOLITI�N <br />CITY OF �VERE77 PERMIT SERVICES <br />3200 Cedar St., �verett, WA 98201 425�257-8810 FAX 425-257-8a57 www.evereriwe.org <br />���'' � 7r.._L'?�k=� S �1�, <br />LEGAL for new constructlort: Short Plat/subrJlvlel <br />owrv�r� ��11� ��F,l•�� <br />4ddress I� OS ��'��� �'j�'� <br />APPLICANT: Owner <br />CONTRACTOR ��� <br />S [ (�l� N <br />Phon�/E-tnail <br />GftylState/Zfp <br />�x+� �� PER11T# �`Q�� <br />No- (Rttach cGpy of fong I�gai deBCrlptfon) <br />�� ��� � � <br />_.�v�e�rr, ��v� � �,�o r . <br />OWnor's Agent � Contractor � Contrflctot's Agent _ 7anant (mue� prwida a�e�Der olconaen� rrom In. �ar ta do wo�k �n me apa�0� <br />�UILDINa P�RMIT qPPLICATIQN <br />State Lic. # �}�lJ �- <br />(qj -U l + Phone/Em�U o <br />CONiACT FOR PERMIT <br />��T`f l�� L� <br />CpNTRACi PRICE OF WO�dI( <br />L�J <br />Bus. Lic. <br />Exlsting Use of Building HEAT SOURC�� <br />Proposed Use of 8' Gas Electric dther <br />Bullding type: 5ingla �amll �,17uple�c�Town Multf-Famify � Commercial . <br />T e of ro'ect: New Addltlon Remod I� Re alr T,I. Si n S rinkler DemolEtion • Chan e of Use <br />DESCRIP"fION OF WOF2K (aaertrona�suece pro�raedon e ack): <br />��/ � " �- � 1� E C� �- � �l' �l.�l� <br />� �� <br />MECHANICAL p <br />Type of I�ruject: _New�Addn „�a <br />ShvwNumber offlx! <br />�C — afr han <br />Forced �ir s <br />Gas I ln <br />Water h�ater <br />Gas flre lace <br />G�s ren e <br />_ _ Clothes drver <br />SPRINKLE'R <br />APPLICATIQN <br />Exhaust fan <br />Heat pump <br />Uhit heater <br />�oiler <br />Refriger�tlon <br />Woodstove <br />Ducting <br />Othor <br />� <br />Number of Meads <br />units <br />TyPo of <br />P4l1MBING PERMIT APP[.IGATION <br />��au� �Addn �Alter�tlon _Repalr <br />3LtowNumber(#1 oiflxtures <br />Medlcal Gas <br />Other. <br />bael <br />I hereby cattl�y tltat I haVe reaq ynd examineA thls S4pllcatlon e�tl Kt1oW lhe eeme l0 bo lrUe end Cbr��p�. All provlglon6 of lewa end ordlnan4os go�eming tlila type Ol WOYIC wlll be GOmp <br />wlth wne[h0� speciFled hereln p� not. Tho yronlln� of a permlt tloes noi presum� to q{v0 euthovlty �o vlalate or cen0al llte Drovlelon pf eny Olher etale ar loG�� �9w YeflulatlhB conetruotfon <br />That I pm sUtNorized by lhe owner of thle propoKy to perForm Inm work Forwhlch appllaatlon la m;�de and I camply wlth the 9tale CO�tfOGtOrs Lew'18.2T f�Cw erltl 296,200A WAC. <br />/ � ��� �I � <br />�w g� uthorfz9d �nt 8lgnature Dete <br />(Revlsed 4✓2016) <br />