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03/23/2016 WED 14: 00 FAX Fast Water Heater U0Q2/003 <br /> 'ERMIT APPLICATI - <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8910 FAX 425-257-8857 www.everettwa.org <br /> - 103 <br /> sm lP� ssy-_1 ST Sj PROPI R T # P RMIT t! <br /> LEGAL for new construction' Short Plat/subdivision Lot No, - (attach copy of long legal description) <br /> OWNER Ki---1-14 V co Co_ I� phone/E-mail tj 2 Xcb <br /> Address -5S 51/0 — 3 City/State/zip �V le._ ��`•wt} 7r3.-0 3 <br /> APPLICANT: Owner Owner's Agent Contractor Contractor's Agent Tenant(must provide a tetter of consent from Ne owner to do work In the apace) <br /> CONTRACTOR • it 41 1 A . -c-g- HAThk,, State Lic_# FAST VJ J k1"h"1 City Bus. Lic_# ?) <br /> Addros6 I 116. N 1 le_E. - 4--VUY L 0 IAP, - Phone/Emelt orlrj (a 3 04 i 4 ,A--f• <br /> TENANT BUSINESS NAM CONTACT FOR PERMIT LhH i <br /> -e-v-, i <br /> 1� NI '- -i- -)E-- <br /> Phone/E-mall i Lf hu-Me`I � <br /> BUILDING PERMIT. <br /> APPLICATION CONTRACT PRICE OF WORK 410 <br /> • "/'N <br /> ..... <br /> Existing Use of Building ,V \ 12 D HEAT SOURCE! <br /> Proposed Use of B Y " t M Gaa Electric X Other <br /> Building type: i Ingle Family Duplex Townho Multi-Family Commercial <br /> T .e of .ro ect: Now Addition Remodel da Ti. Sign Sprinkler_ Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the beck): <br /> P}AA-0\re--Ar,e,pla Gz_ -0-____Cfc-,- uucci-eir Luovi-ui— <br /> MECHANICAL PERMIT APPLICAT ON PLUMBING PERMIT APPLICATION <br /> Typo ,fProject: New__Addn Alteration_R^•air Type of Project: _New_ Addn _Alteration Ropglr <br /> Show Number # of fixtures <br /> _ Show Number(#)of fixtures <br /> A/C—air handling un Toilet <br /> 111 Forced air item Bathtub <br /> Gas piping Laveto wash basin <br /> Water heater Shower <br /> Gas flrepla Kitchen sink&disposal <br /> Gas ran Dishwasher <br /> Clothe; dr or Clothe a Ill _ <br /> i re hood Water heater <br /> • oust fan Sink(ser' - mopletc.) _ <br /> Aft:LpeuamteprBackflow preventer(inside bId)Urinal <br /> Boiler Drinking Fountain <br /> Refriger; Ion _ Floor drain <br /> Woodstovs _ - Grease trap _ <br /> Ducting Roof drains <br /> Other __ Medical Gas <br /> r' ' RINKLER / SUPPRESS I N SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify That I have read and examined this application and know the earns to ee true and correct.All provisions of laws and ordinances governing this type of work WPI be comp <br /> with whether specified herein or not,The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I em authorized by the owner of this oropeny to perform the work for which application Is made end I comply with the Stale Conlrectore Law te.27 RCW and 296.200A WAC <br /> 'er4DILIA 3 - - <br /> C 3 - 1 (0O / ut orized Agent Sign urs Date (Rev/sed 4/2096) <br />