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06/ia/20i6 TUE 9:�9 Fax Fa�t water Heater �pp2/005 <br />��Rnn��r ����icA�r�� 1�2��� . <br />E'3UI�DING/MECH,ANICAI./PLUMBING/SICN/SF'RMNFC�.ER/DE�IIIOLI�10�! <br />CITY OF EVERETT P�RM17 SERVIC�S <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 4,25-257-8857 www.everettwa.org <br />TE AC)DR�53: �l�' � _ Qr.t-�y �/ (�� PR�P �A # [/V (,J / U� P�RMI�i# y / ni <br />� / �r1 Cr� O v ,/ <br />� <br />GAI., for new cone�ructlon: 3hort Plat/subdlvlslon Lat No. (ettach copy Of IOnB legal descrlUtlon) <br />VNER � ^ y'�� �'� <br />Phone/E-mqil <br />ireaa � S�j Clty/StatelZlp �� <br />PLICANT; _ Ownar � Owner's Agent Contraclor _ Contrector's A ent Ten n <br />9 _ fl t(muel provl8e a leqvr of consenl ham Ue owner � do work In Ina spaceJ <br />ONTRACTOR <br />BVII.�INa PERIV�IT APPLICAi'IdN <br />State Lic. # <br />�� <br />Phone/�malf <br />��� ���� <br />Phone/E-msil <br />COfJTRACT PRICE O� WORK <br />�xistEng Use of Bullqing �� ' <br />f'ropased Use of Bull ' <br />BuIlding typa: -nqle Famil _ Duplex_Town Mufii-Famlly _ Commerclal <br />'i' e of ro eot: ew Additlon Remo I Re r T'.I. Sf n S <br />DESCRlPTION OF WORK (eddifrorr�l spac� p�d(de �� ; <br />�.�� �-'�!�' �� �_ � <br />� <br />MECHAMICAL P�RMIT APPl,ICATIdN PLUMBINQ PERMIT APPLI�ATION <br />Typa of ProJaci: �New �Addn _,A{taration _Rapalr Type of ProjecE: N Addn <br />_Aftoratlon �Repatr <br />Show Nvn�ber �! oP flxtures S ow N bar Of flxfures <br />A/C — air handlln units oNeP <br />Forced alr svsteme � ,�...� <br />(-'I.�S E�.City Bus. LEc. t� _� <br />� la 3 wr r-��S <br />cn � <br />eY <br />�AT SOURCE- <br />s E16CtHc Oth�r <br />Demolitlon . Chanpe of Use <br />�Ct�m �..Qc� <br />Water heater <br />_ �as fire lace <br />oas range _ <br />Clothes dr er <br />Ran e hood <br />Exhaust fan <br />Heat um <br />Uni# h�a�r <br />Bofler <br />Refrf oration <br />Woodstove <br />Ductln <br />Other <br />PRI �V KLER�SIJ.p�R�SS10N� <br />5ho r <br />Kitche slnk 8 <br />Dlshwa er <br />Clothes she <br />Water hea <br />Sink serv <br />Ciacicflo rev <br />Urfn <br />Dr in Fount <br />oor drain <br />Grease�trap <br />Roof dralns <br />Medical Gas <br />Ol�er: <br />I htl�by certlF}r that I havm reaa antl efcaminad thlB eppq0atlon and know d�g same to be Iru� and comPct. All provlelone of lews and ordinanpeg 8overning lh{s type nf yvp k wlll 6� comp <br />„+fth whethor apmpllled hereln or not, Tho qcanung of � Dermlt dogy nOt preaume �p g�ve aulhorlty 10 woiate arcancel Ih0 OfOvlalon o�any 011tar slale or locel faw rp�ulatfng consln,cUO� <br />Thel I em eullior+z�d by lha awnar oF thle proper�y �v periorm Ihe Wprk Porwhlch applf60tlan le mBUO 21r1d I comply wlth tfte State ConlractOrSlaw '18,27 RCW and 296.200A WAC. <br />W �f• 1 �l � <br />Owne rl d Agen IgnQture Date <br />(Ravlsed 4/2p�g) <br />