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11/21/2016 MON 11: 07 FAX Fant water Heater i�003/006 <br /> ERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 4,25-257-8857 vm w.everettwa,org <br /> SITS AI]ORES Pb 610 p"Om A # P IT ^O <br /> LEGAL For naw construction: Short Plat/subdivlslon Lot No•_._ attach eo 'rV/\1If <br /> � copy of long loggl desarlptlon) <br /> OWNER G S Phone/E-mall � � �" <br /> 5- t <br /> Address O� 4� C /o City/State/zip <br /> APPLICANT:—Owner Owner's Agent Contractor ContrRator's ant <br /> w T9nq f1t(muel provlde o letter of con6eal from the owner to de work In the apace) <br /> CONTRACTOR State Llc. <br /> �r G�t� (n� 1Ity <br /> Addres8 I� rte. �">U�/11�1 C' lP L' <br /> ENANT BUSINESS ME JWA. PhoneJEmall a�j(�3 1-1 5 1q1 <br /> CONTACT FOR PERMIT <br /> Phoma/E-mall Z a'-1 <br /> t rr <br /> BUILDING PERMIT APPLICATION CONTRACT PRiCI~OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use <br /> Gas Electric Other <br /> Building type Single 1=a Duplex�Townho Multi-Family _Commercial <br /> T e of pr( act; Naw Addition Remodel �Re a T.I. SI n S rfnkler Demolition Chan e of Use <br /> DrzSCRIPTION OF WORK(additional space provided on the bac1c) <br /> MECHANICAL PERMIT APPLICATION <br /> PLUMBING PERMIT APPLICATION <br /> TYPO of Protect: _Naw—Addn —Alteration Repair Type of Project: ---Addn _Alteration Repair <br /> Show Number # of fthires ow Nu bar # of fJxfur®s <br /> A1C–alr handlln units Ilei <br /> Forced airsystema B thfub <br /> Water heater Gee I La ato wash basin <br /> Sh w <br /> Gas fire lace arKltc en sink& i osal <br /> Gee ran a Dish asher <br /> Clothes dryer Cloth s was r <br /> Ran e hood We orkhAmKarExhaust Pen <br /> Heat um Slnk s vice/bar/mo /etc. <br /> It eater Bac o reventer Inside bld <br /> Boller Ur al <br /> Refrl eratlpn rinkfn untaln <br /> Woodatova Floor drain <br /> DoOng Grease-IFEl <br /> Roof drains <br /> Other Medical Gas <br /> SPRI iKI-ER PPRESSION S) TEM <br /> Other: <br /> Number o <br /> Other: <br /> I hereby gettlfy tF+ot i have r6ad end 6' <br /> to is applloallon and know the aair,5 tube lrum and GMTort.All provfelons of Iswa and ortdihence6 governing(hie <br /> with whalhar 9pecifled herein or not.The granting of a pwrnit does not preaurne to give authority to Violeta or oencel the provlbto of any olfhor stale or local lawpegulaling oonatrucO of work wlll be ol aP <br /> The t I m authorized by the owner of thio property to petrorm the work Por whloth application la mods and I oomply with the 5tvibat*Contractors anYorg Law 18.2 r RCw and 2902ngA wAC, <br /> I - <br /> Awher �thorizedAgar,tgl ature Dlate <br /> (Pevlsed 412oio) <br />