Laserfiche WebLink
09/23/2016 TUE 10:p1 FAx Fa�water Heater �j005/005 <br />pERM�T � �D � _. <br />A�rI�L�C�►�"�iN C.� <br />�UILDIN�1110#ECHANI�,AL/PLUiVIE31NG/SNGN/SPRINK�.ER/bEI11�OLlTION <br />CtTY OF EV�RETT PERIIAIT SERV{CES <br />3200 Cedar St., �verett, WA 98201 425-257'-8810 FAX 425-257-885i www.evere�twa.org <br />ITE Ab RE 3' -r � � L �� pgD D TAX # <br />�� s' � �} � o P �`tT # � - b� � <br />�GAL for ngw ConstruCtlon: 51Tort F'let/subdlvlslon Lot �Io._.. (attaah copy of fong legel tleaorlptlon) <br />WN�R � � D V Phorla/E-In�tll —1 � � ' g0 � <br />�d�ess � p b � s � ��p cityrsc�c�,z�p � �}- �� g <br />'PLICqNT: � Ownar _ p�r,�ner's Agent COntfaCtor � Cont�pCtor's A�ght � Tenant (muetp�{�e e letter o� �anaent hom �ne owner �o do work m the epaaB) <br />R <br />L <br />1-- <br />BUILDI�1(3 PEI�MIT /1PpLICATIaN <br />5tate Lic. #� - �/LJ� <br />�J{4�}- � I { Phon6/Emall <br />�`�l K��-t �,� <br />PRICE OF WOFi4( <br />Bus. Lic. <br />G�3lo��'-? /�r� i-FS <br />I�xisting Use of Building ���� �_ HEAT S �: <br />Proposed tJse of Buildl�g Gas ectrtc ther <br />E3uilding type: � Sfngle Family _ puplex _Townho Multi-�amll � Comm�rcfel <br />T e of ro ect; New Additfon Remode Re aI T,I. Sf n S rinl<ler pomolltion • Chan e of Use <br />L»SCR1P'TION OF WORK (additlonel s,vsce provldad on the 6acl�: <br />� <br />���L� "�1r ��'l �. r�l ��� � <br />�-' [�U�r ���- <br />M�CHAN�C,AL pERlVI1T APpLICATI <br />Typa o4 ProJect: _NeK,_qddn „Altera4lon �Repair <br />Show Number oP tlxtUl'es <br />�C — alr handlin units <br />rcad alr svstems <br />Wat r heater <br />Gae lace <br />Gee ra e <br />Cfothes r r <br />Renae nd <br />nit <br />PLUl4t1B1[�G P�RfVlIT AP��.IC,ATION <br />Type of ProJact; �,Naw _�4ddn ,_p,Iteratlon �Rapalr <br />Show NUmber # of flxtures <br />Tollet <br />�athtub <br />La�ator wash basln <br />Shower <br />vasner <br />es w�sher <br />r heater � <br />sarvice/bar! <br />low preventE <br />ng Fountaln <br />draln <br />SPRlNKL� Med�cal Gae <br />RESSION SY$l'EM other: <br />N�imber o <br />Other, <br />� <br />I hereby qerllFylhet I liavo rAed �nd exam�ned Ihla appho&tlon end know the samo to 6e q�ua and cairyct. All provlslon� vF lew� �nd ordlnpnaea govarning Ittl6lyvo oPwork wlll be comp <br />wlth whefher epeolpe�i hereln p� no1. Th� �ranling of e p���� �oa� not preaum� � glve BUIFtoNty So vl0��fa ar Gmnce! the provl§Eon o� any olher atate or locel Isw regVlqNhd caneilua�lon <br />Th�� I� butho�lze by Ehe owher o� lhl� proper to perform the work For whl�h appllcallon la maae ahd I compiy W�fh the Sttete Contraotors �aw 18-27 RCW en� 290.200A WnC. <br />�/�� !IV <br />Own�r/A orized Agent Slgnatur� qete <br />(R�v/sad 4/2096J <br />