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Jan 06 2017 01:56PM Washington Water Heaters 8663757454 panp 1 <br /> _ PERMIT APPLICATION <br /> M:ECHANlc <br /> BUILDIN 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_everettvva.org <br /> SITB ADDRESS: PROPERTY T�v� � vD_ 20PERMIT# <br /> LEGAL far new constructionr Short Platlsubdmsion Lot No. _ <br /> ( (attach copy of long legal description) <br /> L. <br /> OWNER �V l ( LL LPhoneE-mail �0 I <br /> -" 3 <br /> 3dress ln-yCl�L UQy / /*2 7 <br /> Citylstateop <br /> APPLICANT; Owner `Owter',Agent _Contractor Contractors <br /> Agent _Tenant(mum prov de a icUe of cense t flan C e v mecM do co k n he pn�) <br /> CONTRACTOR a,5h f J'7 1 f 1 <br /> } r State Lia# �/� f-I ' t <br /> � Q�/City taus).Llc.# <br /> Address "'; , ,%; �i i :;`, /� �'_�l.r� iti'-' ;,' t .i7 e�,' ': 79 O 5W 4 <br /> •?i(- - } _ �i =i Phone/Ealai) (�(j nI ALU ' VI�C��y� <br /> TE ANT BUSINESS NAME Co TAC FOR PERN_fIT / !L[ I <br /> 6LDlLD1NG PEI M1fT APPLICATION Phone/E-mail <br /> CONTRACT PPJCE OF WORK �3( Ff.'5 <br /> i)dsting Use of Building / <br /> HEATSOURCE <br /> Proposed Use of Building—­­,_ <br /> Gas Electric Other <br /> Building type: —Single Family _Duplex Townhouse —Multi-Family _Commercial <br /> Type of project New Addition Remodel Repair., T.I. S" n _Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project _New—Addn _Alteration_P,-,pair Type of Project: _Now_Adun _Alteration Repair <br /> Show Plumber fix <br /> of tures Show Number .. of fbaures <br /> A/C-air handling units <br /> Toilet <br /> Forced airs stems Bathtub <br /> Gas " "n Lavato wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&dls —os­71 <br /> Gas range Dishwasher <br /> Clothes dryer <br /> Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mo etC. <br /> Heat um Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinicin Fountain <br /> Refrigeration Floor drain <br /> W ve Grease tra <br /> Ducting <br /> Other Roof drains <br /> Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other. <br /> Number of Heads Other: <br /> I hereby certify that I have read and examinod this appkcation and know the same to be true and mrreci All ravysims of tsws <br /> trill whether specmad herein or not.The granting or a p ar>s!°rdinancas gaveming thlc type of work m7 be comW <br /> 9� 9 permit does nal presnrme In gtv auttwnny to violate oreancej the provision or any other state oriocai taw tam <br /> a m authorized by the owner of this pm to � 9 construction <br /> perform work farwJt'sch a pC�catign is made and I comply with the Sta&o Contractors Law 1827 RCW and 296200A waC" <br /> !Authorized Agent si hire Date <br /> (Revised 9/1014) <br />