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Oct 24 2016 02;49PM Washington Water Heaters 8663757454 <br />page 1 <br />PERMIT APPLICATION <br />BUILDIN IIAECHANICA PLUMBIiVGISlGNISPRfNKLER/DEM(.1LITtON <br />C1TY OF EVERETT PERMIT SERVICES � <br />3200 Cedar St., Everett, WA 982�1 �25-257-8810 FAX 425-257-8857 wuVw.everettwa.org ' <br />AbDRE3S; <br />TA}[ iF <br />�� <br />GAL for new constructfpn: Short PlaVsubdivision Lot Plo. (attach copy of long logal description) <br />dress <br />0 <br />•2 <br />?LfCANT:,_Owner _Ov�nersApent _ConVactor _ContrdctorsAgent _Tenant(muStPro+rdeatanurdconsen�t�om�neownerioao��x„me��e� <br />N7RACYOR (,��/ d�(,/� a Siate Lic. # �,(1/�- Ci Bus. l.ic_ # � l✓`J� <br />ress �� r1V-lL-V.G�� _O . l/j y(� / f V v(/i- q__�V PhonelEmail �()Q--9 7) -�;/� WQKi a1 Mdlbf� <br />UiLDiNG PERMIT APPLICA <br />�� <br />PRICE QF WORK <br />cisting Use of Build"sng �—�- '� i.� ��•"' �� "' — <br />HEAT S�URCE: <br />oposed Use of Building Gas �'�%�lectric Other <br />�ilding rype: � Single Family _ Duplex Townhouse _ Muiti-Fami[y � Commercial �.�( (,4y",Z i'�.�:c (.�; Fr .' <br />rpe of project: _ Piew Additlon Remodel Repai� T I 5iqn Sqrinkler Der�ibfit�ors Change of Use <br />ESCRIPTION OF WORK (aclditronai space provided on the back): /,,� <br />, � 1�.� �� c,�J �e�� �S� <br />���� �� <br />� <br />MECHANICAL PERMIT APPLICATI <br />7ype of ProJact: �New _Addn _Alteration _Repair <br />Show Numh er (f�) of flxtures <br />-- I v!C _ ��r hn.,.rr.... . �.,:a.. <br />' Gas fireplace <br />Gas ranqe <br />Cicihes dryer <br />Range hood <br />�`Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />ReTriqera6on <br />Woodstove <br />Ductinq <br />Other <br />iNKLER I SUPPRESSlON <br />� Number of Heads <br />PI.UMBiNG PERMtT APP4ICATION <br />Type of Project ,,,,�New____Addn �AlteraUon____R�pair <br />Show Nambe� (i�) of f»rfures <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bad <br />Backflow preventf <br />Urinai <br />Drinking Founlain <br />Floor drain � <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other; <br />I hereby certi:y fhnt 1 nava readond examined lhls application and know 1ha same ta be Wo and wrtad. P,II provlsFons ollaws and ort7inances govemmp Ihis type ofworkwt! be mmp� <br />wllh wttetfier spgdfled t�ereki or not. TTe praminp o!a pertni� daes nat pres���u,,,nnnyyy111e lo yNe authortty to violale or tancel the provision of any othar stale or local law regulatinfl conslrvqion <br />Thaf I am aulhotized by the owner oi this property to parrcrm Ihe wofk Torwt�t eppUqtion is made and 1 comply wilh ihe Sta[e Conlrado[s Law 16.27 RCW and 29G200q WAC. <br />�%% ,�' .(�`�'�"� ,t � �,c��LL�...' ``�� �C'� i�:j-i �, <br />OwnerlAu�horized Agent Sig�ature Date (Reviseaf 9!'t014) <br />