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LO/05/2p16 wEo 10:39 FAx Fa�t water xeater fd0pz/�05 <br />, <br />. . Rnni� �►p��ica►�r�i � ���I � ... <br />BUILC)�NGlMECWANICAL/PLU111NBINC,ISIGN/SPRINKL.ERlpE�U1iDLIT�ON <br />CiTY OF �VERET'r PER�V117 S�RV�CE� <br />3200 Cedar St., �verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />P <br />J <br />GAL For naw eonstructlon: Short PlaQlsubdlv�alon Lot No. (attach copy of long legql deacrlpflon) <br />vN�� " � �' 1(�-) � Phone/�-mafl � � � aa <br />�roee I C �� Cfiy/Statelzlp � g�� <br />PLICANT: � Owner � Owne�'s AgenC � COf1ff�CkOf ` COntrBCtOf�9 AgBht _ rg�ant (mustpravide e tet(eroFppnaenl Ram (�s own�r (a do wo�k fn Ihe sppaq) <br />�P�Vu�-r <br />State L.ic. ;k� ' vU�l� �' U � Ity Bus. Lic. <br />�J - f ( PhonelEmall �,j (� � � ��yl, <br />CONTACT �OR PpRMiT <br />�'��1 i���li� / <br />BUILpING PERriA1T APPL.1CpT'IQ�►1 coaT�cT PRIC� oF wOrt►c - - V� <br />�xisting Use of Sullding H�AT SOURC�: <br />Proposed Use a <br />�as �lectrlc Otl�er <br />�Tuilding type; inglQ Famiiy ____ Duplex �'Cownhou Multf�Family � Commerclal <br />T e of ro ect: New Acldltlan Remadel Re alr T.1. Si n S rinkler �emolition . Chan e of Use <br />DESC�LIPiION �� WORK (addltlonsl spac� prowded on e ac : <br />i <br />��� � 1�..� � � �' 'e C �, � �' �, �^ <br />� , � ��� <br />J MECwi4NICp�, PEl�MIT APpLICATIpN <br />Typ� o�Y Projec _Ne Addn T�4ltsratlon �,Rapalr <br />Shvw Nur» r# of flxtures <br />A/ , alr handlln units <br />Forc d alr svstems <br />W ater <br />t <br />Other <br />SPRIN LE1a I SUP�RESSI�N <br />P4UMBING PERNIIT AP <br />of Profecl: `NeW �Addh �q�teratlon _Repalr <br />8how Number f#1 ef firt�..ti,e <br />ICltchen sink & dls <br />Dishwashar <br />Clothes washer <br />Water heat�r <br />Medlcal Gas <br />Other- <br />Number of Heade Other: <br />� hblYvby qeftlly lhat I heve rA71d and eXBmfhed lhlg egpllcatkon and know Iha gpme to ba [Yve en� �rrgot. All proY161one of IeWS and ordlnqhcee govarnl�g lhi6 type of work wlll ba Comp <br />Wlth whether gpeclFled her�ln or not. Tha granryng �{ � pe��� poee nat ro9uma bo N <br />rhat I m autho ed by thQ owner of tFtl roper�y �o perfarm �hg y�ry� Ppr whloh epplrc�l on`le�m'¢�de alnd I�cpmp�y Wltlt U�ie State Cpnt � torah�ewtg,y7IROW ntl 286 200A wqC ollon <br />� �I <br />Owner uthorizaol qgent �naCure <br />at� <br />(Revlsad a/z07b) <br />