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03/16/2016 WED 8: 55 FAX Fast water Heater �VV2/VV3 <br /> _'ERMIT APPL,ICATIC,. . <br /> BUILDING/MECHANICAL/PLUMBINGI/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., (-:verett, WA 98201 425-257-8810 FAX 4.25-257-8857 wvvw,everottwa.org <br /> SITE AD REBS V W P OPE TVTAXlf P MIT# <br /> LEGAL for new construction: Short PlaUsubdlvlslon Lot No. (attach copy of long legal deacrlption) <br /> OWNER PhonelE-mall <br /> Address 0-5 Dr— C(tylSta*Zlp <br /> APPLICANT: Owner OWner'B Agent Contractor _Contractor's Agent Tanant(must provide a letter el coneem rrom thm owner to de,work In the apace) <br /> CONTRACTOR T C. J -� State Ltc.# `/lJW City Bus. Llc.# /� <br /> Address l N ^I' �ULI S j 11 f, D I Phone/Email o�j �j�jZeLew 1'I J f� e <br /> TENANT BUSINESS E CONTACT FOR PERMIT f. <br /> 7-1 �,S�LA-7 <br /> Phone/E-mall L <br /> v <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use or Building S� HEAT SOURCE: <br /> Proposed Use of B f� Ges Electric Other <br /> Building type: r _Duplex Townhouse Multi-Family Commercial <br /> Type of proje& New Addition Remodel Re afr T.I. Sin 5 rinkler Demolition Chane of Uso <br /> DESCRIPTION OF WORK(additional space provided on the buck): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration,_,JRepalr Typa of rojact: _New_Addn --Altaratlon_Repair <br /> Shaw Number # of fixtures Show Number IP of llxfures <br /> A/C—afr handlingunits Toilet <br /> Forced airs stems Bathtub <br /> aS-piping Lavatorywash basi <br /> Water heater Shower <br /> Gas a Kitchen sink Is osal <br /> Gae ran e <br /> Dlshwash <br /> Clothes dryer <br /> olhe sher <br /> Rama hood W heater <br /> Exhaust fanHeak ervice/bar/mo /etc. <br /> Unit heater um ackflo reventer inside bid <br /> Unit Urinal <br /> Boller Drinkln Fou In <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ductlnq Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heade Other: <br /> I hereby certlry that I have read and examined[hie apploallah and know the same to be true end correct.All provisions of laws and ordinances governing this type of work velli be comp <br /> with whether speUlflod hbreln or not.The granumro Ufa pormlt does not preaume to give aulhorlty to violate or cenael the provision of any other efelo or local law regulating construction <br /> That I am authorizad by the ow r or this properly to perform the work for wmeh appllcallon Is made and I comply with the Stele Contractors lav+19.27 RCW end 296.200A vvAC. <br /> Own Author e Agent 9lgnatura J � � p <br /> ate (Ravisod 4/2095) <br />