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08/23/2016 TUE 10: 00 FAX Fa�FTater Heater 0004/005 <br /> PERMIT APPI�rC,��rrON �� <br /> �(� 1 <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-2578810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDR SS: lO� PROP R TAX# rfo"Doir <br /> bl/ <br /> Oder) <br /> LEGAL for new construction; Short Plat/subdIvisfon Lot No. (attach copy of long legal description) <br /> OWNER A Phone/E-mall <br /> Adages db <br /> APPLICANT:_Owner T Owner's Agent Contractor —Con tractol's Agent _Tenant(must provide a lao-rof consent trorri tho owner to do work In tha apecei <br /> CON7'T7ACTOR State Lic.# VUR D <br /> ( – � f I � City Bus-LiC_ <br /> Address L N E- � bU�-1 Phone/Emall a 3 Ln�' -+n 2 -� <br /> f ln)' <br /> ENANT BUSIN S3 NA CONTACT FOR PERMIT <br /> I\ 1 V <br /> Phone/E-mall <br /> BUIL13ING PERMIT APPLICATION CONTRACT PRICE OF WORK °ti' <br /> Existing Use of Building HEAT E; <br /> Proposed Use of Building <br /> Gas lectric Qther <br /> Building type: „Single:F�amily _Duplex_Townho Mul ly _ Commercial <br /> T e of ro'ect: Now Addition Remod Ria a • T.I. Si n S rinkler Demolition Chen a of Use <br /> DESCRIPTION OF WORK(additional*puce provided on the book): <br /> 'PAA1\­6�–el <br /> A . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of proje : _N®w ddn Alteration_R air Type of Project: New_iActdn _Alteration_Repair <br /> Shoal Num r # of I1Xtures Show Number # of flxttrres <br /> A/ –air handlln unl Toilet <br /> For ed air s *tame Bathtub <br /> Gas I Lavato wash basin <br /> Wats heater Shower <br /> Gas ra <br /> Gas fir !a Kitchen sink&disposal <br /> Dishwasher <br /> Cloth r er Clothes washer <br /> R e cl Water heater <br /> xFa FSink service/bar/mo /etc. <br /> Heaatt Lit um <br /> Unit heater Backflow reventer inside bid BolleUrinal <br /> r Drinkin Fountain <br /> Refrl eratlon <br /> Woodstove Floor drain <br /> Ducting Greaseltra <br /> Roof drains <br /> Other Medical Gas <br /> SPRINK R I RESSION EM <br /> Other: <br /> Other: <br /> I hereby oohifythat I Nava rAad and examined lhle appilcatlon and kttow the earns to be true and colre0t.All provlslona of law®and ordinahcee governing Ihir type orwork will be corhp <br /> with whother apeci0od herein or nol.Th®granting of a permit does not presume to give authority to violate orcencel the provision of arty other aceto or local law regulalling congtnlotlon <br /> Thal I am authorlxad by the owner of thle property 10 perform Iho work for which appllcetion Is madd and 1 comply with the*late COMVOCIOra Law 18,27 RCW and 299,200A WAC. <br /> 4. <br /> owner/Au &r * ft <br /> en51gn ura Date <br /> (Revised 4120 f 6) <br />