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05/24/2016 TUE 12: 34 FAX FaFt water Heater- U004/004 <br /> 'ERMIT APPLICATIA L-Lo-Z <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wvwv.everettwB.org <br /> 31TE ADDgE !� <br /> �V g PROP A # D iJ Lf6n ' i21IT -'J 2 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal descrlptlon) <br /> OWNR c�j (t PhonelE-mall y'p 5 <br /> Address ' 2 S� City/State/zip ' <br /> APPLICANT:Owner Owner's Agent Contractor -Contractor's Agent _Tenant(must proWda a letter vfcvneenl from the owner to do work In itlespaca) <br /> CONTRACTOR fAS7F W C—I` Hl--_A State Lic.# vivi�- &—Cit Bus.Lic. <br /> t I E-� �Pw l <br /> Address �- � ��� Inl .. Phane/Email a��(d�j ✓lel <br /> TENANT BUSIIVE NAME CONTACT FOR PERMIT �a �, <br /> IAJ <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK a}" <br /> L <br /> e of Building HEAT SOURCE: <br /> se of Building Das El®cmc other <br /> e; Single Famlly Duplex Townhouse Muiti-Famfl Commerofact: New Addition Remod Re al T,I. Sin S Sprinkler Demolition , Chan e of Use <br /> DESCRIPTION OF WORK(additional specs provided on the back): <br /> MECHANICAL PERMIT APPLICATION MBING PERMIT APPLICATION <br /> Type of Pro/ect: _Naw_Addn _Alteration�Ropair Type f Protect: _ w_Addn _Altoratten Rapalr <br /> Show Number # of fixtures Show bot # Of fixtures A/C-�air handlingunits olfet <br /> Forced airs stems B tub <br /> Gas fin Lev wash basin <br /> Water heater Showa <br /> ffHeat <br /> fireplace Kitchen k&dis al <br /> rainUB Dlshwashe <br /> es dr er Clothes washr/ <br /> Range hood Water heater <br /> Exhaust fen Sink servl /bar o /etc. <br /> um Backflow revente Inside bld <br /> heaterUrinal <br /> rHDrin ' I'ountaln <br /> erationf l r draindstove rutstLE <br /> DU inp Roof drains <br /> Othor Medical Gee <br /> SPRI RESSION SY3 other: <br /> Numb Other: <br /> I hereby canlry that I have read and exemIna d this application and know the same to ba true and correct.All provisions of laws and ordinances governing this type of work wall b camp <br /> with whether spedfled herein or not.The granting of a permlt doaa not presume to siva authority to violets ar cancel the provialon or any othor ytalo or local law raguIoling Gonslrucdon <br /> Thal I dm authorized by t e owner f this prop6rly l�PeIlDrnl <br /> the work Por whlcn�ynpllcatlon Is made ttnd I comply wllh the state Contractors Law 18.27 RCW and 296-200A WAC. <br /> p ®r uthtorfz9d Ag®nt Sionatur® ! C� <br /> Date (Revismd 412015) <br />