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Apr 13 15 12:30p Washington Water Heaters <br />• <br />42 57461563 p .2 <br />• " <br />������ ����������� <br />��&���� R����-9��d����f���d��[��1��C��9,'�PR.�td�����E�O���f9�� <br />��� �� ������ ������ �E������ <br />3200 Cedar St., Everett, WA 982�1 42�-257-881 C3 FA� 425-257-8857 vtnMv.everettv✓a.�rg � <br />5t i E ADDR�SS: �� �l� � � ` ae�Rrr ��;; t� <br />L 5 ���� �ao� _ ►�l 1 �a'-�'�-025 <br />:GAL for new construction: S�ort PlaVsuhdivision Loi No_ (attach copy af fong fegal descripfion) <br />����' �^ � L ^ PhonelE-ma�! �—,! ?J �� � �j� ''�'� <br />dress Z , � �v��'� �C CirylStateJZip l� �'�C.'�, �.J,� � ?��C'� ,qj <br />`�-r - - - <br />CAFd i:� Otivner � prmers Ageni � Coniractor _ Contra�tor's AgEnt � Tenant ����c Proo�aea �e;terorconknc r�n �r,e o,,,,,erio ao �•�orc �n;ne <br />,3 � ' �r <br />/ �, �i <br />,;� v� i� f '.'- GY✓fi:.r_ y� '�` <br />��-' a°flm9�B�'��a r���°�"�0°�" ����fL���"�°���� <br />iata Lic. # fi%�� s'—� ��� I <br />i.=. � .,� <br />�U �U,� PhorelEm2il ����• <br />OIV�'RCT FOh? P�RStif��" ^ <br />v � G°y � :'�1' '�.` i <br />�onelE-mai? �f� i;" � �f ` <br />on� � €�� � ��c� o� vua�K <br />�%�S�Cit�+ 8us. Li�. � !� �„i <br />- .� Y�7 �. , <br />J � U ✓ U J✓��"JUJ'1� ��:/�/ <br />. <br />Exis:i�g l3se oF Building i <br />r HEAi 50URCE: <br />Prapased U5e of Buildi�g Gas E�e�tric Other <br />Buifding typa: T Singie Famity � Duplex,_'Co�vnl�ouse _ Mulii-Family _ Commarc�al � <br />�yp2 af pro;ect New __ Addition Rernociei Repair T t 5iqn Sorinkler Demoli6on Lhanqe cf Use <br />D��C�iP�t�i�l �F 1R(QFZF4 {addurona�sRace pravided on the bacx): <br />% /��^ l'�1��� �. <br />� � � rY -- - -�- f ` <br />�� �/f� �.��`�- y�-' ��%i� �� (�/�/.0 ������ Ir�-�- ✓�'•� ( ��1 <br />J <br />����4���B��� ����'���i' 6������3'0�� <br />of Project; �i�ew qddn _A(teration _Repair <br />Show PJambpr (�) or' �xtures <br />A/C — air handlinq unifs <br />Forced air s siems <br />Gas pi in <br />Water heaier <br />� Gas rireplace <br />Gas ranqe <br />_ CfotFres dryer <br />Rang= E�ood <br />Exhausi fart <br />__ Heat puma <br />Un�E �eater <br />Boiler <br />RefrigeraFion <br />Woodstove <br />DUCtinq <br />' Other <br />�I��B����E� ! �R�9��L���SH�� �'�°��'�G'� <br />I�Iumi�er of Heads <br />c'�'F��66�A�;6�3� e'�E�l��� �������'�`�€�L� <br />of projeeY: ��iewlAddn �Aitera4ion _Repair <br />SFi or� Number (�k) or �xtures <br />Tailet <br />Batht�b <br />Lavafory (wash basin) <br />Shqwer � ' <br />}C3tchen sink & disposal <br />Dishwas�er <br />Cloihes washer <br />Water heater <br />Sink (seruicelharlmop/etc_) <br />Backt3ow prEventer <br />Urt�al <br />flrmking Fountain <br />rlaor drain <br />Grease tfap <br />Roo"r drains <br />� Medicat Gas <br />Ofher <br />I heraby cer�iry giat t heve read and ezamined ihis appli�lion and kaow 1he sama 10 he true anq co�tt. AA provisions oi lati•is ar,d orrlinanczs govemir,g this 3ype af tvor:c wd2 be cornp� <br />f.+dth wheiher speaf�ed hereln oc nol. The granling ot a permR does nat ptesume to gNe autliority co vi❑laie or can.�l rne pmv�c[on of nny other oiate or [owl law regvlaFiny corzstruGion <br />Tti81 m auihorized 6y Ihe otivneref Ihls property I ?Kortn 1he vJorkiorwh:ch app;IcaEon is made an� 1 comply 1vIIh the Stato ConYadors La`•� ]8.27 RCV�/ and 296.ZODA WAC. <br />-�t � l I ✓ J <br />Owr.er/,4uthorized Agent Stgnature Da e (Revr,sed 92�i4) <br />