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01/�5/2u16 TUE 19:a5 Fax Fa�t water xeater �002/00� <br />.. . ... _. . --: - — --��-� ----.....--- ---�------ . _._— .......... . _ . _ .. . _ _ ..... _ . . .. .. . ... ..... . ..... _ . _ . _ .._ ..... . <br />. _ .-� -- -� - - <br />�ERMIT APPLICATI C,'O12�j � <br />E3UIL.DIN�/MECHANICAL/PLUMBING/SIGN/SPRINKLER/D�MCJL�`r'ION <br />CITY OF EVERETT PERINIIT S�RVICES <br />3200 Cedar St., Everett, WA 982�1 425-257-8810 FAX 4�5-257-8857 w�n�w.evereitwe.vrg <br />ADDRES3: <br />�n� 1 Sr <br />Tax rr <br />�� 1 J ��� � <br />LEGAL for new construcdon: Short Pfat/subdlvlslon Lot No, (attach copy of lonp legel descrlptlon) <br />PLICANT: _ Ownor � Ownar's Agont <br />Phone/Gmafl <br />CIly/State/Zip <br />� <br />COfIi�3CtOf � COf1tf0C�0i�8 AQ6Rt _ T9flBflt (m�el provlde e laftar af coneoni from the owner lo Ao waiA In I�e epece) <br />BUILDIN�3 PERIINIT YPP[�ICATI�N <br />Stale Llc. # w1p� � <br />`� l ( <br />�J • Phone/Emafl o <br />CONTACT FOR PERMIT <br />� � ��� VE� <br />Phar�e/�-InQll �'�'�n�lri�i <br />ONTRACT PRICE OF WOIiK <br />Exlstinc� Uee of Bullding �S <br />Proposed Us� of e iiding � S <br />Bulld(ng lype: I� le Famil Duplex_Townh Multl-Famlly _ Commercial <br />T e of ro ect; New Additivn R�mode Repair T I Slgn Sprinkle� <br />DESCRIPTION OF WORK (addll/onQl speca p�ovlded on the beck) : <br />G� <br />Bus. Lic, <br />HEAT SOURCE: <br />Ela <br />.��/�0 V-� �� � Lx �. � S I�IJG�-�-I�".. <br />� � <br />M�CNANICAL PERMIT APPLICATION <br />7ypa of Pro]ect: �New �ddn _Altarativn �Repalr <br />Show Number # of f/xtures <br />_A/C — air handllnq units <br />Gas plping <br />Water heater <br />Gas flro�lace <br />G <br />xhaust <br />eat nu� <br />uucan <br />Oiher <br />SPRI�VKLER / SUPPREBSION <br />Number of Heads <br />of Use <br />PLUMBINa PERM�T APPLICATION <br />vf ProJect: ,�Naw _Addn _plteratlon Repalr <br />3how Number ik olNxturas <br />Tollet <br />�athiub <br />C th washer <br />ater h ter <br />5ink servlc �barlmop/etc. <br />Backflow re� er Inslde <br />Urinal <br />Drinkln Fountain <br />Floor draln <br />Grease trap <br />Roof dralna <br />Medic�l Gas <br />Other, <br />I hereby corllfy lhal I hova read And vxemined lhla applfcellon qnd know the Smme to be true end C01'rAGI. A�I ptbvlalona oF lawe and ordln�nCe6 povorh�hg lhie lype of work wlll ba comp <br />wlth whethar ape�me� harpin o� not, Tho granling oF e permi� �oeS �OI D�aume lo glve aulhorlly (o vlolat9 Or cancel the prowglon 01 d�y Othef at�te or locel faw r�gUlaUny cong(ruoU0r1 <br />Thet I em auihpr�ze0 by Ih owner ol ihla property �o paKorr� Ihe wOri( for whlch eppllcatlon Ig made end I aomply wlih Ihg Slata Conlr2lqo�a Lew 1B,27 RCW anq 2gg-2Q0.� �/AC- <br />� � � l <br />Ow Authorizod Age Igna ure Dat� (Revlsed 4/2095J <br />