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Nov 09 2016 08:55AM Washington Water Heaters 8663757454 page 1 <br /> PERMIT AP ' ICATION <br /> BUILDING/MECHANICA PLUMBING/.IGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wwvv.everettwa.org <br /> SITE ADDRESS:'W(4 �' �J" n/ 5Z' PROPERTY <br /> 0010 J cog 07000 peRmpiI Ili 1 p I I r) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. _ (attach copy of long legal description) <br /> OWNER W d, ` <br /> T a `(Phone/E-mail q25-33---7_ -3-1-7( <br /> 3 <br /> Address i(-&0 0I '4— ii-kt, 9 CitylState/Zip EI e, WA- ISS g <br /> APPLICANT:—Owner Owner's Agent _Contractor, Contractor's Agent Tenant(must provkle as letter/o'r consent from chi,owner to Co work in lime spaco) <br /> CONTRACTOR tia5 (nq n /,{lar-Y I-I-C a�State Lic.# GC)/4t /1--/ --t- l� /U l- City Bus. Lic.# 0 53 yieh <br /> `� • 5,610g ke�'T! ( 11/11-. <br /> 11 , (1�,^//,°7 • n_ JPhone/Email a"r3f a ,ham <br /> Address + fI 1 A� 1 QVc/� ' �co�7�-�5 wary ✓ �' <br /> TENAN EU INES i I 'CONTAC FOR PERMIT / <br /> � 1 . <br /> L Phone/E-mai �Q GI l d 5a•• <br /> BUILDING PERMIT APPLICATION, CONTRACT PRICE OF WORK <br /> �Y � <br /> Existing Use of Building �Slfp —A `- HEAT SOURCE: <br /> Proposed Use of •Iding Gas ' <br /> Building type: ingle Family _Duplex Townhouse _Multi-Family `Commercial C ''' 4.4441:146644140 i <br /> Type of project: New Addition Remodel _Repair T.I. SIC n Sprinkler—_Demo I I Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 6 11/16 V ,c teef)ta_u_ f -e i-ed-ri L 04f/--� 4,cul-67- i's j <br /> MECHANICAL PERMIT APPLICATION ' PLUMBING PERMIT APPLICATION <br /> Typo or Project: Now_Addn _Alteration_Repair Type of Project: New_Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(ti)of fixtures <br /> 1 NC-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping • <br /> Lavatory(wash basin) <br /> Water heater • Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood I Water heater <br /> } Exhaust fan ' Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> i <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease <br /> Ducting • Roof drains <br /> Other °• <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of HeadsOther: <br /> 1 hereby cedly that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comr <br /> with whether specified herein or not.Ito granting ora ported does nut presume to give authority to violate or cancel the provision of any other state or local law regulating constriction <br /> at.are authorized the owner of/property to pe lrrm the work for which apptcation is made and I comply with the State Contractors Law 18.27 RCW and 2g8.200A WAC. <br /> ,O• ler/Authorized Agen Signature Dafe (Revised 92074) <br />