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11/09/2016 WED 13: 10 FAX Fa5-L water Heater U003/0011 <br /> 'PERMIT APPLICATIO 65� <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Lverett, WA 98201 425257-8810 FAX 425-257-8857 vvvvv.®verettwa.org <br /> SITE ADDRBBS: p OPERTV T X it I p� IT <br /> 10 , f <br /> ILEGAL for now con8tructton: Short Plat/subdlvlstah —Lot No. (Attach copy of long Inall doacrlption) <br /> OWNER US I � G L, Phone/E-mall � I <br /> Addre6s 1 1 YPj � t;lty/State, V 1 <br /> APPLICANT:_Owner Owner's Agent Contractor —Contractor's 1 <br /> Agent _ _Tenant(muel Provide o latter orconoont from the owner to do work In the epece) <br /> CONTRACTOR pp n '� - State LIc,# V'JW� T&—City Bus. Llc. <br /> Addross l I� I � <br /> S �/ InI Phone/Emall U1 3 Y✓fil l l`S -As-44_4e <br /> TENANTtJS1NE NAM CONTACT FOR PERMIT <br /> Phone/E-mall 1;7P7 <br /> �, � <br /> t3UILDING PERMIT APPLICATION CONTRACT PRICE OF WORK N KI IX <br /> Existing Use of Building NEAT E; <br /> Proposed UZ=t�� <br /> EE7ce.] otriC Other <br /> Building tyAlex Townhouse _Multl-Famlly Commercial <br /> Typo of roact: New Addition Remodel <br /> e a T.I. Sin Sprinkler I7emoiltlon Chan e of Usa <br /> DESCRIPTION OF WORK(additional saece provided on thv back)' <br /> MECHANICAL PERMIT' APPLICATION PLUMBING PERMIT APPLICATION <br /> TyPa of ProJect: _Now--Addn _Alteration,_Rap Typo of Project: New_ <br /> YP 1 Addn _Alteration Repglr <br /> SH mbar # of fixtures Show NumbaY # of fixtures <br /> C air handflnU units Toilet <br /> For ed airs stems Bathtub <br /> Gas In <br /> Water eater Lavato wash basin <br /> Cas fir lace Shower <br /> Goo ran a Kitchen sink,&disposal <br /> Clot YO nlshwasher <br /> an aa <br /> Exhaust Water heater <br /> Heat Sink service/bar/rno lot,, <br /> Unit ater Backflow 2ravarter Inside bid_ <br /> Bol r Urinal <br /> frl uratlon L)rinkl nq f=ountain <br /> oodstove Floor drain <br /> ullf"I'Mri x I Greaseltra <br /> Other Roof drains <br /> SPRIM ER / SUPPI�E5S10 Y$'rEryl Medical Gas <br /> Other: <br /> Number of Heads Other; <br /> I hereby Q8HIry that I have riled and examin6d thle e17p110atlon and know the aeme to be tive and correct.All provisions of lewe and ordlhances governing Ihle lypa of work will be camp <br /> with whethar epeclAed herein or not.The granting of a permit does not preaume to give authpllly to vlolet9 ar carpel the provlQlon vFeny other state or local law regulating oonetrucltan <br /> Th t I am Buf orlZed by(he�Ua property to porform 1110 Work Par whloFl applloklflon 19 made and I pOmply with the 916t®Contractors law 78.27 RCW and 268.200A WAC. <br /> owner/Authorizool Agant Signature _ I <br /> Dot® <br /> (Pev/sod 412015) <br />