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05/19/2D16 THU 10:01 FAx Fa�t water Heater �pp2/p02 <br />, <br />�ERMIT AP�'�,��A`��� � l � � � _._. <br />BUILDI6VGl�ECHANI�AL/PLUMBING/SIGN/�PRINKLER/DEfVIUI�ITION <br />�17Y OF EVERE7T PERMIT SERVICES <br />3200 Cedar St., Ever�tt, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />IT� <br />In <br />7# <br />GAL for new canstruction: Short Plet/subdlvlslon Lot No. (attaoh wpy oP lOng leqal descrlptlon) <br />VN�Ii 4� � �i' TI � U �J/ � Phonel�-Insif �' 'T � —� " � � �- <br />iross ( l � St � CifylState/Zlp �% fl� g� <br />PLICANT: _ Ow�er � pyy��a�g p�ent ContrpCtor „ ContraCtor's Mgent _ Tens�t (muet prov�rie e �eNerQ��onsant fram ine owner ro uo waru �n �he <br />ONTRACTOR <br />BUILDING PEF�MIT APPI,ICATIOI� <br />State Lic. # <br />� <br />Phone/�mall <br />�NiAC1' FOR PERMIT <br />�� �F�-�L� <br />RACT PRIC� UF WORK <br />, 1� �,cit �us. Lic. # �� J < <br />��3 v�, �-F� -f�: <br />t�-f2� <br />''� �I��EH 1.�'. On. -�St-t,t.�-� � <br />�xlsting Use of Bullding � �G AT SOURCE� <br />I�roposed U8e of Buildin �� pas EfectrlC Olher <br />Bullding type: Slnc�la Family Dupl�x Townhouse Mulil-Fam11y � Commercial , <br />T e of ro"ect� New Addiifon Ramodel �e a� T.I. Si n S rinkler Demolition • Chan a of U5a <br />I�ESCRIN`TION OF WORK �edditrona� space prov�decf an the eck) _ <br />��� `�-�!�'.� %� � S �,�-Q,� <br />MECHANICAL PERMIT APP�,ICqT1�N <br />of project: _Naw Addn _�llteratlon ��epaEr <br />Gas <br />— alr hancilfn units <br />ed alr systems <br />sr heater <br />fire Iace <br />ran�,-,�e _ <br />ies drvar <br />Refrl9er <br />Woodsto <br />Other <br />rvumber o4 Heads <br />NG PERMIT APPLIC4TI <br />aw _�1ddn _Atturatlon _Fiep�ir <br />Num6or 6 of ffxlures <br />Tollet <br />Bethtub <br />Dish sher <br />Clothes ash <br />Water hea <br />Sink ser c ar/ <br />Baakfl reve � <br />Urin • <br />Dr' kin �'ounlaln <br />oor drain <br />Gregs�ltr�p <br />Roof dralns � <br />Medlcal Gas <br />Otlier: <br />Other; <br />I her�by cett�fy If1at f heVa read �ntl 0xamined thle appllCstloh and know the aAmo to be trua entl oorrBol. Afl pro��slone o! faws end ordlnancee governing thl6 Iypo oF work W�li De aomp <br />wlth whethar speclfled hereln or not, The grenlln� of A p�rmit daee not presuma to glve eulho�lly to vfalale ar cantml N1e Dravl�bn oP eny otlt�r 9tala or lacal law regul9��ng �pnglnactlan <br />7h t 1 yrn authorized by the owher oF thle proparty lo perform the wprk fpr Wn�ch appllcatlon 19 Made and 1 comply Wlth the 9lete Con[ractOra �aw 18.27 RCW end 298.200A WAC. <br />Ow�� rlAutharfz9d A�ent $Ignqture � � � I <br />�ate <br />(F'av/svd 4/2015J <br />