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Aug 29 2016 11;25AM Washington Water�eaters 8663757454 pag� <br />,-�—�-- --- - <br />j,: --_ \ <br />� '�. <br />PERMIT AP ICATI N�r(� ���,�.� C��U� �� <br />�-,J'� � <br />BUILDiNG/MECHANICAL PLUMBlNG! !GN/SPt��KL.�ER/DE� LIT-� N <br />�� � <br />CITY OF EVERETT PERMIT SERVICES ``'�.�� ' �--"----"` <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evere�fw`�.-orq '" � <br />G�.�J�� �.a-l�Ill� ��� <br />'T 1�i��1 l�d U � �T�l � �' � I <br />'aAL inr new cor�truction: Sfiart PlaVsubdivision Lot No. (attech copy of long legsl dascription) <br />'NER � C �- Phone/E-mail QW� W ( f S ��J� ( � � � <br />ress `�ZJf`�--,._���_�e.,--=l..w�,CO_' L...._��--� CitylStatel�iP �C_.I. V K� (/�-/ l � G <br />_ Owner , Owner's Agent _ Contracxor _ Contractors Agent � Tenant fm�� p�oYae a ieuer aconsan� rrom u�o owoer io do wo�x m r,tl <br />Q,o�-{.V �'�Q��.S Staie Lic. #�i4 {� � Ci Bus. Lic. # d✓,J <br />�y f��r��/�/� n_ yp <br />V� l� �f 1��� W� ��U�� .� Phone/Email �(j�-� / i—��� WQ �'�%� Mi <br />�1 ��� �f' `L'!'� f��� �%�� -Z�-�� j <br />BUILDtNG PERMIT APPlICATION <br />�CCC�t l <br />;, � p _ o <br />T PRICE OF WORK y <br />Existing Use of Building __ �,(�,'�S�fit�"`-�`( �(-{' � <br />Proposeci Use ot uilding <br />Building rype:�ingle Family _ Duplex _Townhouse _ Mulii-Family _ Commerciai <br />"fype of project: New Addition Remodel Repair T.I. Si n Sorinkle <br />i?ESCRIPTION OF WORK (additionalspace provideuon the beck� : <br />HEAT <br />Demolition nqe of Use <br />�u <br />f'�0 U� ���,/�C..C� �� ��L�l � l�c�G��-P,� ��.�� �S� <br />MECHANICAL PERMIT APPLICATI�N PLUMBiNG PERMIT APPLICATION <br />Typeof ProJect: _Now,_Addn ,�ANerafion _Repair <br />Show Number (#) qf frxtures <br />I A/C—air handlina units <br />Clothes <br />heater <br />Othe� <br />SPRINKLER ! SUPI <br />� Number <br />of Araject• _New _Addn _/�ILerat[on _Rcpalr <br />Show Numbar (#) of fixtures <br />�nower <br />Kitchen sink 2 <br />Dishwasher <br />Clothes wash <br />Water heater <br />Sink (servicei <br />Backflow pre� <br />Urinai <br />Drinking Four <br />Fbor drain <br />Grease trap <br />Roof drains <br />Medica( Gas <br />Other: <br />Other: <br />t her�py oerN(y that I have read and examined Ih� eppiication an ow the sama ta be true and correct All provisians of laws and orclinancas goveming this lype of work will be wmpl <br />wflh ar speUtlad herein or noL The g 'np of a pertnit a s ot presume to qlve authority tn ubla[e or cencel the provfaion aT any other slate er locat law regWallne consVupion <br />al l am uthorfzed by Ihe ne af fs p e bpartorm it� ork Torwhlch eppiiphon is made and I oomply with tha Stefe Contractors Law 18.27 RCW end 296.200A WAC. <br />`�� � "`,�' � "z� � <br />0 erlAuthorized Agent 5ignature Date � (Revised 9/2014) <br />