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05/16/201 <br />N 1g:29 FAx Faat water Heater <br />OOG/ODG <br />. ... <br />_ _ - <br />. ���MiT AP�LrCA�`�� d <br />SUILDING/�1II�CHANI�AL/PLUMBIA�G/SIGN/SpF�M1V�LER/D�N14�,11"ION <br />CI'TY OF EVERE77 PERMIT SERVICES <br />3200 Cedar St., Everetf, WA 96201 4�2�-�57-8810 FAX 425-257-8857 www.evereitwa.org <br />1L for new congtiruction: Short PI6t/subdivfslon Lot I�a. <br />�R ��'J�i 1 L �i���'�. I- �5 � Phoiie/E-mail <br />iress <br />/ ' � � � � � U �G v Clty/State/z <br />ALICANT: _ Ownor � Ownar'9 Agent ContreCtor � Contrg�tor's Aqent <br />BUILDIh1G P�RMIT APP[,lCATION <br />(rzttaah copy o} long 18ga1 descrlptlon) <br />T@flAflt (muel provlUa s letNr ofwn�ent from Ihe owner lo do wnrk fn lne ypAca) <br />State Lia. t� W�tJ f—' ���it Bus. l.ic. <br />�,�j U(� phone/Emal! `�?�'� (�j 3 yy <br />CONiACi FOR PERMIT <br />�� ��L� <br />'honeJ�-m�il �¢,�� „�,i �'�i��l �!!�� .0 ( .G � <br />PRIC� 4F WORK <br />I Exieting Us6 of BuUding � �Al- SOURCE; <br />Proposed Use of pae Elac�rlc othar <br />Bullding type: � ingfe Fami _ Duplex �3ownhouse Multl-Family _ Commerclal , <br />Type of pra)v_ct: _ New Additfon Remodel eoai � T f Sign 5prinkler Demolition Change of Use <br />DESCRIPl'lON OF WORK �sadinon�� s,oece prowdea orr r� back) _ � <br />��� �r� �� �� c��-� �..�c�� <br />� <br />MECH4N�CAL p�RMIT APP1,�C4TION UMBIN� PERMIT APPLICATION <br />ype of pro�ect= _Naw _Addn �Itaratlon Repa r Typa o4 Pro ec Naw Addn �Alteratlon _Rapair <br />SNow Number # oP flxfures ow Numbar # Of !lXturee <br />A/C — air handiln unlfs Tollet <br />Forced alr S stems Bathtub <br />SPR <br />Water heater <br />Oas flre lace <br />Qas ren e <br />Clothes d er <br />Ran s hood <br />Exhaust fan <br />Heat um <br />Unit heater <br />Boller • <br />Refrineratlon <br />V�OOd3f6V9 . <br />�ucting <br />Other <br />I`S PRESSION S' <br />Numbor of Hg� <br />Drinkin <br />Floor d <br />Roo? dralns <br />Medlca! Gas <br />Other: <br />Other: <br />sld� <br />I hereby cettlry �hat I havo raed end 9xalnlned Ihls appllcaUon and know the a&ma to be lrue and oaK�ol, All nroWelong o� �aws end ordlnancgg govefning thi6 type oF work wlll pe vomp <br />wlth wnother speclfiod hereln pr not. Tha grenting oM a permit doea not preeume lo gfve eulhorl{y fo vlo�ate or certC01 �tte provlalon o(any olhmr st�te or locel law regula�fng �onxtrucHon <br />T� i I$m eUlhtorized by the awn�� of thle properly Io perform the work fpr w��loft appllcetion 19 m�de and I comply wfllt lhe Stete Contraotory �aw 18.27 RCW and 2QQ-200A WAC. <br />_��`�� <br />�w r rfaad Age Slg e ure Data (Ravlsod 4/2015) <br />