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02/10/2017 FRI 12: 24 FAX Fast water Heater U004/009 <br /> 'ERMIT APPLICAR L. 6 <br /> BUILD ING/MECHANICAL/PLUMBING/SIGN/SPRINKL"ER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425.257-8810 FAX 425-257-8857 www.evereftwa.org <br /> SITE ADDRESS, PROPERTY TAX 4I � PERMI #n- <br /> LEGAL For new cornetruction: Short Plat/subdlvlslon Lot No. <br /> (attFich copy of long legal descrlptlan) <br /> OWNER S Phone/1--mall <br /> ll <br /> lLiad�� Cltyl�tate/zip \ <br /> APPLICANT: Owner —Owner'a AgentContractor Contractor'a Agent Tenant(moot proviaa a fetter of conount from the ownv to do work in ine apace) <br /> CONTRACTOR11 �j State Lic.# mn,i <br /> Address ' Iv kE 4*-vvW C� <br /> S (✓ inJ' Phone/Email ��(�3 y -� I-�-� �,� �� <br /> BUS.INESS NA CONTACT FOR PERMIT - <br /> �� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE O1=WORK <br /> Existing Use of Building <br /> I-I EAT C�: <br /> Proposed Use I <br /> Geta Efeclrf Other <br /> E3uildlnfl typ®: 'Ingle Fa ! _Duplex_Townhouse Multi-Family —COMMOT-Cl91 <br /> T e of rohect: New Addition Rernode a a r T.I. Sin S rinkler Demolition . Chane of Use <br /> DESCRIPTION OF WORK(addiflonal Space provided on th®bock): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projact: ddh i�Altaratlon_Rupalr Typo of ProJact: —Now Addn <br /> Show Numb # of flxtura$ — _�Iteratlon Rapalr <br /> AIC air handiln unit3 Show Number tl ofl/xtures <br /> Force alr s stems Tollet <br /> Ga e I Bathtub <br /> Water he for !,avato wash basin <br /> Gee fire I e Shower <br /> Gas ran a Kitchen sink&dis oral <br /> Clothes dr Dlehwashef <br /> Ran e hod Clothes washer <br /> Exhau an Water heater <br /> Hoa um Sink service/barlrno /etc. <br /> U heater Backflow reventer lmMde bld <br /> oller Urinal <br /> Refrl oration �rinkln Fountain <br /> W oodstove Floor drain <br /> Lhictln Groass Xtra <br /> ther Roof dralno <br /> SPRINIC ER / PRE`'SSI- - 1STEM Medical Gas <br /> _ other: <br /> Number of <br /> Other: <br /> 1 h"Oby QettlFy that I haVQ rdad and 4malnhad thle appfloatlon and know the game to be true and och-ect.Ail rovfalons of Tawe and ordihencee ov®rnin thio <br /> Work wIll be corrp <br /> With Whether apeOifT®d heroin or nut.The gfanfing of¢t permit tloer not pre9un a to glue authority to violate opcencgl the provf aloe of any other 6feta or local law pgguldllhg construct or+ <br /> Th.' <br /> I am utharlg by the own®r of thio property 10 perform the work Far whlof+appllCatloh Is m®de and I cOmply wlth the State Contractcre Law 19.27 RCW end 290.200A WAC. <br /> Own®r/Au zed Agan �Ig aeur® <br /> D e tat <br /> (Revisod 4rz015) <br />