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12/29/2016 WED 10: 45 FAX Fast Water Heater f�0p4/005 <br /> IJEERMI'T APPLICATION L2- 11 11 <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., I-:verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> nr <br /> SITE ADDRESS: O� ` PRO FRTYT # =' T <br /> boj� <br /> LEGAL for new construction Short Plat/subdivlslon Lot No. (attach copy of long legal doecrlptlon) <br /> OWNER ���� � �� ��b�j Phone/E-mall 2Q-2 M13 <br /> Address D� V Clty/State/Zip (� — 9 F� <br /> APPLICANT: Owner Owner's Agent ContraCCor Contractor's A ant <br /> Ag Tenant(ri Ftprovl de aletter al consent from Ihs owner to do work In the sprigs) <br /> CONTRACTOR , Stats L.ic.# WW} <br /> T�Ity <br /> Address Phone/Emali o� �fl�� c"-M 1 ! S (Lt <br /> TENANT SINE5S ME CONTACT FOR PERMIT r. <br /> 1 ` � ��UC l <br /> Phone/E-moll I <br /> BUDDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> lzxisting Use of BuildingE7 <br /> NEAT SOURCE: <br /> Proposed Use of g <br /> Gas Electric Other <br /> Bullding type: ingle Fami _Duplex—Town Multi-Femliy —Commercial <br /> T e of roject: New Addition Remod �Re r T,1. Sin Sprinkler Demolltlon Chane of Use <br /> DESCRIPTION Or;WORK(addlUongl spt�ce provided on ack) <br /> MECIHANICAL PERMIT APPLICATION PLUMBIAG PERMIT APPLICATION <br /> Typa of Project; _New-_Addn _Alteration_Ropalr Typa of Project; _Now__Addh _AltoratlonRepair <br /> Show Number r# of fixtures Sh umbe of flxturvs <br /> A/C,air handllnq units Toilet <br /> Forced air s stems t3alhtub <br /> Gas I In L.avato ash beeln <br /> Water heater Shower <br /> Gas the lacy Kitchen elnk die�osal <br /> Wpump <br /> no Dishwasher <br /> s dr er Clothes wash r <br /> hood Water heatar <br /> Exhaust Pan Sink servlca/h r/mo /otC. <br /> Heatum Backflow revs to inside bid <br /> ater Urinal <br /> Drinkin Foun Inration Floor drain <br /> tove GrepseRoof sins cal <br /> SPRINICL RU.-t-SPRESSIO STEM Gas <br /> Other: <br /> Number Other. <br /> I htifevby geftlrylhOt I have read and bxalnlned Ihle 3ppHoatlon And know the same to be true and CalreCt-All provISluns of[awe antl ordlnaneos overnln thla <br /> with whether 90eclFled heraln or not.The granting of a permit does not presume to Iva authoritynif9 g ry oCal law ra of work will ulatIng si camp <br /> Th6t I am authorized by the ownar or this property to perform the work Far whioh application Is ads and I comply with tha SIt feprovitbCont eclorany b Law 19.27 fRCw Arid 298 2DOA WAC,ctlon <br /> O Ized eht <br /> gna ra / <br /> Dat® (Revised 4/2015) <br />