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05/2G/2016 TUE 12:39 Fax Fnst water Heater �009/V�a <br />. . . .. ---. . <br />_... <br />��r�nn�� A���r��►�'r� Co l � � o _.._. <br />BUILDING/�VI�CHAN�CAL/PLUIVIBING/SICN/SPF��NKLER/DEMOiLITION <br />CITY OF EV�RET'i PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98241 �25-257-6810 �AX 425-257-8857 www.everettwa.org <br />SIi�E rhDRR Si� ��i �/' 1\'� � 0/`��O � PRO �R1V AX# ��V ��RMI7# _ <br />� � 1�.�1 <br />LEGAL for new constructlon: Short Pfqt/aubdlvlslon Lot No. (attach copy of long leg�l descrlptlon} <br />�WN�Fi J Phon�/E-mpil ��5 3� 3 s <br />Address �� � � �►'i Clty/State/Zlp ��� �� � ' <br />APPLICANT:_Owner ,�Owner'$Agant ContrqC�Ar _Contractvr`aAgent _T@tldnt(muetorovmealetterarmnnantfromtheownerroaownrklntheepaou) <br />CONTRACTOR '� �� State l.ic. # <br />Ww !- g ��f B�S. ���_ <br />Addre95 � l�l� IV (�� �f"��/V"1 S��L^ � Ui � )� <br />�� ��i'�/lP.l' � _ �1I�- PhonelEmall '70�� �rJ �(n���i /.]P,Yd�I ��5�@ � G-r.� <br />� <br />BUILDING PER�Vi1T APPLICATION <br />PRIC� Op WORfG <br />IExlsting Use of BuiJding a{�� HEAT SOURCE: <br />Proposed Use o'F Qas Eleetrlc �ther <br />Buflding type' Sinflle Family DupleK Y7ownho Multl-Famlly _ Commerclal . <br />T e of ro'�ct New Addition Remadel Re air T, I. 5i n � rinkler Demoiition • Chan e of Use <br />DESCRIC�T'ION OF WORK (edditlonal space provlded on the ac }: <br />��� �� l � � S ��,fGt�#�Jr <br />� <br />' M�CHqIV�CAL P�RMIT APPLIC4TfON <br />Typa oP proJecE: �Flew`Adqn �Iteratlon �Repalr <br />SPRIN <br />A/C — air handllnq unite <br />Forced afr systems <br />ater heater <br />Unit heater <br />Boller <br />Refrfger�atlon <br />Woodstnve <br />Ducting <br />Other <br />PR�SSION <br />Number of <br />UMBINO P�RMIT IkPpLICATI <br />of Projact: New _Addn �,qftaratlon _Rapair <br />Si►0 Numbsr ef ffXtulea <br />I Tollot <br />Kf en slnlc & d osal <br />Dish asher <br />Clothe w er <br />Water � ter " <br />Sink erv e/bar/mo /etc.' <br />Sa flpw r enter Inslde <br />nal <br />Drinkln Fountal <br />Ffoor drain <br />Grease�tra <br />Roof dralns <br />Medlcal Gas <br />Olher: <br />Other: <br />� <br />I heredy certl(y ll1a� I hs�Vo reod arltl mxamined Ihle eppll���lon ahd know the asm� to be Irue end Cbt+'BCL All provle�ona pt laws and ordihancea gove�ning 11116 rype oF Work wlll be COfhd <br />With whe�Yier sp�aifled hereln or �ot. The grenting of a p�rmit does not preaumA fo glve suthort�y to vlolate or c�nCm� Ihe proVis{on of eny othg� Slet� o� loca� ��w reguleting con9lrucUan <br />That em eUthorized by 1he ownor oF thls property lo pertorm lhe worK for whl0h applfcelfon Ig m�de and 1 camply wUi1 l�e Slale Cantractora l,dw �g,27 RCW end 298.200A WAC. <br />� - 2Ll- I �ri <br />Ow Auth a Agen Igne re �ete {Revfsed 4/2076) <br />