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Feb 25 14 02:05p Washington Water Heaters 4257461563 p.1 <br />� � <br />IIl11T APPL�C�4T1QN <br />B[�ILDihlC�1MECHA�iCA,4/P1.UM�ING/SIGN/SPRft�K�EE?JDEMO�ITI��r! <br />CITY OF EVERETT PERM[T SERVICES <br />3200 Cedar St, Evereti, WA 98201 425-2�7-8810 FAX 425 257-8857 www.everet#wa.org <br />APPLiCA�IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />!TE ADDRESS: � � PROP�tT.Y�x #, PgR_MtT # <br />i��G�� �� �L'`� ��' `�1�.�G� L� Ul(.�.JC�aaIZL�ZDU I�al�l(�i.c���" <br />EGAL for new cansWction: Short PlaVsuhdivision Lot No_ (aUach copy of tong legal description) <br />WNER 4�� ( c �'J!l l�-F� Phone/E-mait L�2�j. �j7��- ZS'��7C%��y�`?���ZZ�ZZL�. <br />jdress ( �'U� J ��'� /�,�'1/`� (/l,I `.��C7 c�ryisr�cerz�P C;i�-��`�°�� l�J�� � z��� <br />PPLICA�IT:_Owner �O�me�sAgent �i�, Co�tractor _Coritractoc'sAgent _Tenant�m�i�n�;eoateaerota�R�,terammern.nerwd�wan���soao�� <br />r <br />CONiRACTOR �t��L�('�! �v�'u" f�'� Vr !C•� LI�� ;^i '�1�}'7�C� r� L& I Lic. # L{,'/�- �r' �'�` % o'� <br />1 � < <br />Addtess ��(,�L1 i[1 i�`1'��J 1l G; J 1 �� 1-t i� �� G�i.� �l Jf��U'� dyC�(, -1 <br />� � � � Phone/Email � <br />'fEPfAidT SUSINESS NAME CaIYTAC7 FOR PERMIT <br />�ti /�� �1 c;.C.C.� j�Cts'tt c z; , <br />PhonelE-mal � �_ r�� �� ' <br />�l�d�D1�1G PERi1111i APPLfCAT10N , CONTRACTPRiC�O� WORK <br />E�nsting tJse of Building I�� l�'''�� •' �i � <br />Proposed Use of Building <br />Building type: T Single Famiiy , Duplex�Townhouse ulii-Family � Commercial <br />Type ofi projeCt _ New Rddition Remodel _ Repair 7.1. Sign Sprinkle <br />QESCRIPTtON OF WORK (additional spaceprovidedon the laack}� <br />' �L,� Lt l`J�-r'•� I'�`,� �-'�''� <br />�- <br />����1 C.�--��'� C�� C � �,�..,r � '��C:�=;� ; <br />� J <br />NIECHAlNiCAL PERIViI'� APPLICATiON <br />Type of Project_ _New Addn � Alterat�Dtt� ��pa r��`'� Type <br />Show Number (#) of fixYures <br />A/C — air handlin units <br />Forced air svstems <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range ho�d <br />Exhausi fan <br />Neat pump <br />Unit heater <br />Boiler <br />1 �tJPPRESSIO� SYSTEM <br />iJum6er of Heads <br />C.'•(" CQ E Bus. Lic. # <br />,? <br />1r-- r��;� J��c�1c�,`�i.fc,'Yyi�.�' <br />� �- � ���,: <br />CCt1'� f-Tz��fZy <br />HEAi SOURCE: <br />� Electria O[her <br />olition Chanae of Use <br />PLI�MBI�IG PERMIT APPI.ICATiQ6�i <br />ofProjecr WNew Addn AlteraYion�Repair <br />Show Number (#) of 6xtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shrnver <br />Ktchen sink 8 disposaf <br />Dishv�asher <br />Ciothes washer <br />Water heater <br />Sink (servicQJbar/mop/etaj <br />Bacicflaw preventer <br />Urinal <br />Drinking Fountain <br />Ftoordrain <br />Grease trap <br />Roof drains <br />NEedical Cas <br />other. <br />Other. <br />I herehy certify fhat 1 have read and e�rnined Ihis applrtatian and fmow ihe same to be true and corTed. Ap provisbns of faws an6 ordinances govem�g lhis type of work w�li be compGed <br />\wilh whethei speclfied heroin ornot. The gcanUng oF a permil oes notpresume to give authority ro violate orcancel the provision of any otherstatQ ar loca7law regulating consuuction <br />Th&f 1 am au7hor¢ed by 1he ovmerof Ihis fpperly to perlo e work forwhich appGcation is made and 1 comply wilh Ihe State CanUactors Law �8.27 RCW artd 296.20DA WAC. <br />I ' r I <br />, ; ' �� �, �,���'' � � �,�,u-c, J �-Z�l � � C� ��� -����C C�-'�:� �� � 4�y��� �- �fc <br />� � �� ��. <br />- /1 f �r1� � ! \�LL/yL <br />fJwnerlAuthorized Agent Signature �� G�� pa� I.,�-' �"� �• L�-�'��'v^ (Revi � 6l20�2) <br />