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10/05/2016 WED 10: 34 FAX Fabt water Heater 0 U005/005 <br /> SERMIT' <br /> APPLICATION iiq19 <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 www.everettwa.ol <br /> SITE AD 1RWSS: <br /> 0 <br /> 17 <br /> L PRO R x g o0 - �- <br /> LEGAL,for new construction, Short Plat/subdivision Lot No. (attach copyCof long legal descrlpllon) <br /> OWNER ` C U Phone/E-moll <br /> Liv l O� <br /> Address ��� Clly/Stale/Zip <br /> APPLICANT:—Owner —owner's Agee Contractor Contractor's Agent 9 ____Tenant(must provide a fetter a(coneent rrpm the owner to tlo work in the apace) <br /> CONTRACTOR n�`� — � State Llc.# UUW'— Cit Bus, LIG. <br /> Address L { � N _ � `f1/vL(' C— Ole <br /> S0,(p �1f Phone/Email �5 r) <br /> TE A BUSINESS AME CONTACT FOR PERMIT77 <br /> Phone/E-mall i Y <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> E=xisting Use of Building HE=AT SOURCE: <br /> Proposed Use o <br /> — Gas Electrle Other <br /> Building type: incdle F y _Duplex—Townhou Multi-Family _Commercial <br /> T e of ro ec1 Now Addition Remod Ree T.1. SI n Sprinkler Demolition Chan a of Use <br /> DESCRIPTION OF WORK(addltlonal space provided onthe bacic): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TYPO of ProJa3ct: _Naw--Addr. •_Altaratfon`Repair Type of prof® 49W_Addn _Alteration_Rep <br /> Show Number 22 of flxturas ShoW umbar t of flxturaag <br /> A/C—air handlln units Toilet <br /> Forced airs stems ollet <br /> Gasointnin Vathlub <br /> L vator wash ha <br /> Water heater <br /> Gas Sh war <br /> fire lace i<Itc n sink IS osal <br /> Geis ran e Dlshw sher <br /> Clothes dryer Clothes char <br /> Ran a hood Water ter <br /> Heat eatExhaust fan Sink ery a/bar/mo /etc, <br /> Hum <br /> Unit heater B flow venter inside bid <br /> Boiler Anal <br /> l�elri ewatlon Drinkln Foun In <br /> Woodatove Floor drain <br /> Duating Greasa Ira <br /> Other <br /> Roof drains <br /> SPRIINKLE pRESIMedical Gas <br /> EM Other <br /> _LTNumber <br /> Other: <br /> I h®reby gertlry that I have rdad and+axamined(N3 apploatlon end know the same tv be true and caiTect,All provigiong <br /> of laws and ordinancea with whether,specified herein or not,The granting of a permit does not presume to gNa suftrlty la violets or cancel the p ovlhlon of any elf ar state or local lla�wPegulatlWe ong cork lnsl uctl tie o <br /> That I r aulhortred by tho owner of thle prop ty to perform the work for which application to made and 1 comply with the State Contractora laaw 16.27 RCW and 296,200A WAC, <br /> N K P(� <br /> Owner! uthprizAd Agent Sfgnatura <br /> - � - [ <br /> _(e <br /> Date <br /> (Rev(sed 4,12075) <br />