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Aug 02 2016 02:26PM Washington Water Heaters 8663757454 <br />• <br />page 1 <br />• <br />PERMIT APPLICATION � <br />BUtLDIN MECHANICA PLUMBINGlSIGN/SPRINKLER/DEMOLrrjol� <br />CITY OF EVERETT PERMIT SLRVICES • <br />3200 Cedar St, Everett, WA 98201 425-257-8810 FAX 425-257-8857 wNrw,everetfwa.org � <br />aooREss; <br />rax # <br /># <br />for new consWdion: Short PlaVsubdivisi0n Lot No. (attach cqpy of �png iegel descripfion) <br />n .�_ ,_ .� <br />Pho,��-ma�� t4a5� a <br />JJ VW%VVi �(�1[.7L. rn� - ICitylShdtelZip �. ��� �(.� 01�� <br />-- �... '-1..� �L.r <br />�Owner _Ownersqgent _,Contractw �,Coniractor'sAgent _Tenanifmustprortaeateneramn�itromaxaw,a,w <br />yv � vrc u� /// � (l / u,�--�,r J� (�/uJ Staie Lic. # (,IJfF /� � <br />16 �%� Rl�7Ll.i' S l�l� k� 1� d%.�!�.(,(. l� 9�6 PtwnelEmail <br />' BU iP{�SS NANIE C�NTAC FOR PERMIT <br />�acc,� <br />_ Phone/E-mail 51/�(1 � <br />BUfLDiNG PERMIT APP�ICATIO <br />RACT PR10E OF WORK <br />Bus. Lic. <br />Existing Use of Buikding ��(.,� �(�iJ�'`ti' lX�`f'` HEAT 50URCE: <br />� <br />Proposed Use o i mg Gas Electric otl�er <br />BuflQing Type: ingle Family _ Duptex Townhouse _ MuIB•FamTy _ Commercial <br />T of ro'ect fVew Addition Remodel Re air T.f. Si n S rinkler pemoiition Chan e of Use <br />�ESCRIPTl01�i OF WORK (add�'tiona� space provided on the back): �� <br />�i UV�. � �. �G�'-�C� � �/.1� 1�.� G'-�" �S� <br />� P <br />� <br />MECNANMCAL PERMIT APPLICATION <br />pe of proJacr r,New_�ddn _�q�teretlon _Rspair <br />Show Num6er of Rxtures <br />Inic _ a�� ti�.,,.�:..,. , ,....,. <br />Gas <br />Clo <br />SUPPRESSION <br />PLUMBING PERMIT APPLICATION <br />7ype of ProJect: �New Addn ,�Alteration �Fiepelr <br />Show Number (#) of �rxtures <br />� Toilet <br />. o_.�...� <br />Shower <br />Medical Gas <br />Other; <br />� herebY cert7fy that i have read and ezaminad this appiioatlon and Imow the aema to bo Ws and correq. AO proWsione o! lawa and «ainrnoes poveminp this type ot worfc,va! be compl <br />whether spadf�sd herom or noL rria 9rnniing o� a p�rmlt aoea nal prcaume to g1r0 9uUtortty b �Iotate ar cancd Ino provlslon of 8ny oH1er state or I�caf taw reputaling conswaion <br />Tha! I aulhorized by the owner of this properly to �fotm Ihe wark forwh A��� � and I complywilh the Slale CatWsdors Law '18.27 ACW antl 2982(IOA WAC. <br />_� � � <br />� <br />9dAuthorized Agent Signatu � <br />(Ravised 920i4f <br />