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06/14/2016 TUE 9: 49 FAX Fdbt water Heater 0003/005 <br /> HERMIT APPLIC.ATfdo LL5 9D 9 ---. <br /> BUIL DING/MECHANIC,AL/PL,UMBING/SIG N/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 PAX 425-257-8857 vwvw.everettwa.org <br /> SITDb SS. ly / %,w� <br /> PR P R # ���D/ O P>=/�gRMITF!" 0' P 1 <br /> LEGAL.for new connsstructlon: short Pini/subdlvlslon Lot No. (attach copy of long legal description) <br /> ,1/ <br /> OWNER N 0 Phone/E-mail d <br /> Ad0rees CA5 i ub Cltylstatelzlp ]�V&relo <br /> APPLICANT: Owner _Owner's Agent Contractor --Contractor'9 Agent _Tonont(must prm Ida a IeQer vrconaent from me owner to do work in(ha apace) <br /> CONTRACTOR �j H State Lic.# UIJIItI cityBus. Llc. <br /> Address l � � VUR6f1/ W J( ( Phone/Ernall a`j(r!3 ✓1�1 !� fit �� <br /> E U INESS NAME CONTACT FOR PERMIT <br /> �-N K <br /> Phone/E-rnafl <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK °v <br /> Existing Use of Bullding ,nn HBAT C' <br /> Proposed Use of Bullding r t Gas E(ectrlc Other <br /> Building type: ____,Single Family _ Dupiex_Townhot. MUM- emll _Commercial <br /> T e of ro ect: New Addition Remod® Repair 'I: Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(addttlonal space providad err <br /> MECHAINICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ofPro a New_,Addn �}�Itoratlon_Repalr Type of Project: Now_Addn ­Altoratlon_Repair <br /> Sh w NUmd®r # of flXfuli Show Ivum6ar # of fixtures <br /> A1C—air handlin units Toilet <br /> Forced alr systems Bathtub <br /> ©al i in Lavatorywash basln <br /> Water heater Shower <br /> Gas fire lace <br /> as ran e Kitchen sink&disposal <br /> lothes d er Dishwasher <br /> Clothes washer <br /> Ft n e °Od Water heater <br /> 0IMPRINKLER <br /> x st fan Sink service/bar/mo /etc <br /> a um Backflow reventer inside Old <br /> nit ater Urinal <br /> oiler Drinkin Fountain <br /> errl er iron <br /> loodatc Floor drain <br /> Greaswtra <br /> uctln Roof drains <br /> ther Medical Gan <br /> SUPPRE ION SYSTEM other:umber of Heads Other: <br /> I horoby cortlfy Ihat I have read and examined thls appllcatlon and know the earno to be tele"no oorreot.All provlelonn of laws end ordlnenees govorning(his type of wort will pe comp <br /> with whethor speelnsd horeln or not-The granting of a perrrlit does not presume to glue sulhorfly to violate OF cancel the provision of any other state or local lawragulet ng canstructfon <br /> That f am au ftr;zad by the owner pr thla property to parrorm the work for whICh application is ureide and I comply wl(h the State Contractors law'16,27 RCW and 290.200A WAC- <br /> \ �3 A A I A (p-1 �j <br /> — i <br /> ow r1Aut rlxmd Agen Igna Date <br /> (I?evlsod 4/2015) <br />