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09/01/2016 THU 13: 02 FAX Fabt water Heater U004/004 <br /> OERMIT APPLICATION L_ja±b_� _ _ <br /> BIJILDING/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 wvvw.ev6rettvva.org <br /> SITE R SS: � � � ntj` pROP�R T # <br /> LEGAL for new construction: Short Plat/subdlvielon Lot No <br /> (attach copy of lone legal desarlption) <br /> OWNER PhonelkIL, 6 IV —7— <br /> Address J �. F �� V v� � � ^ ,n <br /> City/State/,Zip LOA d-(J <br /> APPLICANT: Owner Owner's Agent Contractor _Contractors Agent `Tenant(must pwVida a loner orconaont from the sumer to do vrk In me epacn) <br /> CONTRACTOR State Lic.�# II 0 p� � <br /> rr II nn w r' T F-CCIty Bus.Lic. <br /> Address l l I IV PKUU�� ,-P— �° l ( _ 1 /� <br /> Phcna/mail 1 1 I r� <br /> TENANT (NESS ME CONTACT' FOR PERMIT Ca�fP✓,L�� <br /> �1''rt�-1 ���l,� <br /> Phone/E-mallLFxef� <br /> BU11 ILDING PERMIT APPLICA'T'ION CONTRACT PRICE OF WORK -6 °V' <br /> Existing Use of Bullding <br /> —HEAT SOURCE: <br /> Proposed Use of Buflding Gas lectric Other <br /> Building type: T Sfngfo Family _Duplex Town Multi-Famlly Commercial <br /> Type of rooct: New Addition Rsmod I Re afrSin Sprinkler Depioiltlon Chan o of Use <br /> DESCRIPTION OF WORK(a(icutlonsl space provided on a acA): <br /> MECHANICAL PERMIT APPLICATION P ' I+IG PERMI i' APPLICATION <br /> Type of Protect: _Naw Addn kr <br /> Alteration—Repair Type of P ]Act Now ddn <br /> ­Alteration Repair <br /> Show Number # s Show Num r # offixtures <br /> fflGas <br /> n units To t <br /> $ <br /> meBath b <br /> Lavato wash basf <br /> Shower <br /> tacoKitchen sin 8 s oral <br /> eDishwasher <br /> dr erClothes wood Wator h ater <br /> fan Sink <br /> ervfce/bar/m Jetc, <br /> Host um Bac ow reventer In de bid <br /> Unit heater U nal ' <br /> Boiler <br /> /OrInking Fountain <br /> Refri eratiorl <br /> Wodstove Floor drain <br /> Ductinc <br /> Other Roof drains <br /> SPRI Medical Gas <br /> PPRES3I�N STEM other: <br /> Other, <br /> I hbreby gartlrythat I have raved and ex9minad this application and know the earre to be true and COMM,All provislons of Tawe and ordlnsnces governing this <br /> with whether sPeclfled herein or not-The gren <br /> That I ttng Ufa Permlt does not Presum6 to give authority to violate ar cmcel the provtslon or any other etste or local row regufellma aalnatruc on <br /> am authorized by the weer or Ihls Property to perform this work Por whloh epPlloatfon Is made and 1 comply with the Slate Contractors Law 10-27 RGW and 206.Z00A WAC. <br /> Owns o zo A419ryf e Oa®I <br /> (Rovlsod 4/2015) <br />