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11/21/2016 MON 11: 03 FAX Fast water Heater j006/006 <br /> . ERMIT APPLICATION �� (..._e <br /> BUILDING/MECHANICAL,/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, WA 98201 425-257-8810 FAX 425-257.8857 www.everettwa.orcg <br /> SITE ADDRESS: . a IQD ' t) P[}gpE ,AX t lir <br /> T <br /> \L q -C Y-ftl <br /> LEGAL for new construction! Short Plst/subdlvlslon`• ___ Lot No. (attach copy of long legal description) <br /> OWNER `� �us Phone/ W-mall o (.4' L )C) /, �� <br /> Address _ ,u N , AV City/Stale/ZIP . \f j I A A dx <br /> ggo 3 <br /> APPLICANT: Owner Owner's Agent Contractor Contractor's Agent Tenant(m.el provrne a le ttor of conuonl from Ihek owner to do Work In IM 0pace) <br /> w <br /> CONTRACTOR <br /> C``TTOR .A k 'FA-' ! State Lie.# �� �I-o �Cll Bus. Lie. •q� - <br /> Address L l 7 II_ .7. ,Pvu�t> C--�:a , t°( I <br /> (AJ Phone/Email 95 (f13 v . 4 C 4/1 rf`S a-� <br /> .-A ti <br /> TENA .• :USINES TAME CONTACT FORv PERMIT rwi ti\-f-e.�'.G yt�l <br /> Phone/E-mall ��if n�� _.� �' }(, &r-A21-bu?ceKk. (,- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OP WORK � -.. -1/45---1 <br /> °� <br /> 4 <br /> Existing Use of Building____S_f HEAT SOURCE: <br /> Proposed Use of Su .! s <br /> Gat Electric Other _ <br /> Eullding type: (Single Femil Duplex Townhouse Multi-Family ,Commercial <br /> • <br /> T e of.ro'ect: New _ Addition Remodel ►_.Rees r. T.I. Sin S.rinkler Demolition,. Change of Use <br /> DESCRIPTION OF WORK(adrift/oriel space provided on the beck): <br /> PAA10\r e 4 Y-4pt4 cc_ .___, ., tALGI-ur. lifuovf-e4---- <br /> MECHANICAL PERMIT APPLICATION <br /> ' ti ? ING PERMIT APPLICATION <br /> Typo of Project: Maw Addn _Alteration Rapalr <br /> TYP® • Project: No Addn Alteration Repair <br /> Show Number . of fixtures <br /> Show Nu ber of fixtures <br /> A/C--air handling units r .Ileit <br /> Forced sir systems MIN ga. tub <br /> wt� Gaa + lf. n <br /> �MWater. 111111111101. Lay: o wash basin <br /> MIMMIlir <br /> Gas fireplace � 1S,hyo,,w.. <br /> Gas ran a 111.111111.1 Dfshwa sink&ft.. al <br /> 1111111 Clothes dr er 111111111111.1.1 <br /> Dlshwas <br /> ElliallialaRanee hood Clothes w:shQr <br /> Exhaust fan Water heatill ili <br /> - <br /> 111.111.111=11 <br /> Heat gttm. •ar/mo /etc. <br /> IIIIMMINE Unit heater _ Backflow p ev: ter(Inside bidg) T <br /> Buller Urinal <br /> Refrf aratlon - ll711.1Drinkh ■ Fountain <br /> Wvodstove <br /> Flog drain <br /> Ducting G'=ase'tree <br /> Other "oof drains `— <br /> gp • I PPR ' Medical Gas <br /> STEM MK r Other: <br /> Nug.= 'sada <br /> _ - Other: <br /> I hereby gortlry that I have read and eXamined this application and know the eame to be true and calrect.All provlafons of law&dnd ordinances governing thtt type of work Mil be comp <br /> with whether specified herein or not.The greeting of a permit dopa not presume to give authority to violate or cancel the pravlSion of spy other elate or local law regulating congwotlon <br /> Th• I am authorized by the owner of'his property to perform the work for which application in made and I comply with the State Contrectora taw 16.2.7 RCW end 296.200A WAC. <br /> CA‘ 4t A to . I , 0 i _ 1 i , <br /> Ow-IF/Authorized Agent 9 gm:urs <br /> Dotk. <br /> (Revised 4/2015) <br />