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06/14/2016 TUE 9: 50 FAX Fant water Heater f(�j005/005 <br /> ERMIT APPLICA,TIC LA2 y4 - <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERMEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-6857 www.everettwa.org <br /> SITE ADn5 �J <br /> JPnRT <br /> LEGAL for new constructlom Short PlaUeubdlvislon Lot No. (attach copy of long legal deacriptfon) <br /> OWNER )IrN(V�,I UI�U C Phono/E-mall L16915,05 4 G / / <br /> Address i -�+657 Clty/State/Zlp V V <br /> APPLICANT;__._Owner _Owner's Agent Contractor Contractor's Agent —Tenant(must provide a latter orconecnt from the owner to do work In Ina apace) <br /> CONTRACTOR .(J -T--/f State Llc.# FAST vj111f ,Z Ecaly,Bus. Lic- <br /> Address <br /> i*t-, t, W Phone/Email �orl j rt?3 e,* l <br /> TENANT]BUSINESS NAME CONTACT FORPSIRM1IT cn few• <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKbv <br /> Existing Use of Building AT SOURCE: <br /> Proposed Use of Building Gas Electrle Other <br /> Building type: Single Family Duplex_TownhouMulti-Fa t y -Commercial <br /> ,Type of project: New Addition Remod Re air T.I. Sin S rinkIur Demolition • Chane of Use <br /> DESCRIPTION OF WORK(additional space proviaod on o acic); <br /> re, Iiit Jr <br /> —420L <br /> MECHANICAL PERMIT APPLICATION UMBING PERMIT APPLICATION <br /> Type of Project: New_Adds _Alteration_Repair Typo of roject: New__Addn _Alteration Rapwr <br /> Show Number # of fixtures Sho Number 1A of firvure9 <br /> A/C–alr handling unite Tollot <br /> Forced air s stems Bathtub <br /> Gasi in avato wash basin <br /> Water heater Ser <br /> Gas fire lace <br /> Gas ran a Kltc en sink&dlsp6sal <br /> Dlsh sher <br /> RUH <br /> s d or Clothes was r <br /> hood Water ha r ' <br /> t fan Slnk s I /bar/mo /eta. <br /> n, Bac w rt3 enter inside bid <br /> ater <br /> U al <br /> rinkln Fountaflk <br /> ratton Floor drain <br /> oveGrease tra <br /> Other --�tz Roof drains <br /> Medical Gas <br /> SPRIN OPPRESSION SYST <br /> Other: <br /> Number of Other; <br /> I hereby cert fy that I have read and examinod this application and know the same to be true and correct.All provisions or Iowa and or'dlnoncee governing this typo of work wtll Be comp <br /> With whether epeclfled hereln or not.The granting of a permit dose not prawme to give alAhOrlty to violate Or cancel the provlaion of any other atato of local law regulalhig construction <br /> That[am authorized by thri own r of this property to perrorm the work for which application Is made and I comply with the Slats conlractorb Law 19.27 RCW and 296-200A WAC. <br /> �wnerlAuthorl7ed Ag 31gna urs .-- I� /I <br /> date <br /> (Revised 4/2015) <br />