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08/04/2016 THU 13: 19 FAX Fa9t water Heater U003/004 <br /> tERMIT APPLICATIALLL `4 (-P <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 VA"-everettwa.org <br /> SITE ADDRESS: PROPERTY TAX it TQP, <br /> ERMIT 9, <br /> I�JEGAL fornow oonstructlon: Short Plot/oubdivislon Lot No. <br /> �� I n (attach copy of long legal description <br /> Ft ) <br /> OWN I/Y phone/F-mull r> IJ <br /> 3 <br /> Addrsss D O' Uj C k D(I r� /�e <br /> C/v ui City/9tAte/Zip f <br /> i <br /> APPLICANT:—Owrlor Owner's Agent Contractor —Contractor's Agent _Tenant(rn(isr provldo w tetter or coneant from the owner to da rkIn the space) <br /> CONTRA((CTOR - ��-" State Llc.# �/�{�Lf CIt Bus. Llc. �� <br /> Address 02zC,�- PVU�I �P G I I <br /> S ihonellj rye <br /> E BUSINESSNAM - <br /> CONTACT VOR PERMIT �, <br /> PhonelE-mall e V � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I �01 <br /> Existing Use of Sullding <br /> Proposed Use of Building hIEAT SE: <br /> Gas I®clrfc Other <br /> Building type: Single Vamlly Duplex Townho Mufti-Vamil _Commercial <br /> T e of ro ect; New Addition Remodel -y—Re! air T.1. SI n S rinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(add/tlonal space provided on the back) <br /> 6ek4t4— <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Profec• New—Addn Alteration—Rapalr <br /> Type of prvJ®ct; �N®w�ddn Alteratlon_Repair <br /> Sho <br /> Num t�erof flxturgs <br /> A/C-alr handlin units Shoal lumbar(4)offlrtures <br /> Forced airs stems Toilet <br /> Gan i In Bathtub <br /> Ltavator wash basin <br /> ater heater Shower <br /> G s fire lace <br /> Ga ran e Kitchen sink&—disposal <br /> Clot as dr er Dishwasher <br /> Ran od Clothes washer <br /> Exh s an Water heater <br /> M t u Slnk service/bar/mo /etc, <br /> nit heater Backflow reventer fnelde bid <br /> Boller Urinal <br /> IRefri oration Drlr1k1nQ Fountain <br /> Woodstvve Floor drain <br /> Ductin Greaso-tra <br /> Other Roof drains <br /> SPRINKLER / SUPPRESSION SYSTEM Medical Gas <br /> Other: <br /> Number of Heads Other: <br /> I hereby nertlfy That I have rdad end bxamined this applicailon and know tho Same to be true and correct.All projla1on3 of laws end ordihanceg goVorhing thle type o(work will be comp <br /> With whether apaClaed herein or not.The gfahiing 01'a Pormlt doay not presume to Viva authorfty to violate or canvol the provihlon of any other State or local law regufaling Construrkr, <br /> That I am authorized by the owner of thle propert�Rllllur m the work for whhcn application I9 made enri I comply with the 9tat0 Conlreotory Law 18,27 RCw and 206.200 WAC <br /> Owner! orlxed Agent Ignuture oats - <br /> 0 4/2015) <br />