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10/25/2016 TUE 11! 49 FAX Fast water Heater 0002/005 <br /> OERMITAPPLICAT10101 Li-� q 1 <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DENIDLI°TION <br /> CITY OF EVERET'r PERMIT SERVICES <br /> 3200 Cedar St,, Everett, WA 98201 425..257-8810 FAX 425-257-8857 wwvv.everettwa.c) g <br /> PLEGAL <br /> S IPRbPrRnr # r+�a�e`tT <br /> 11�YY'P„I` <br /> w construction, Short Plat/eubdlvlslon Lot No, (attach copy of long level description) <br /> Phone/Ear!!, as s <br /> Address I CltylState/Zip V W �a <br /> APPLICANT: Ownor Owner's Agent Contractor —Contractor's Agent <br /> _Ton ant(mus!proWdw q leiter of coneon{from the owner to do work In the apace) <br /> 1CONTRACTOR_.' 5T State Llc.# Ed e t?ECClty Bus. Llc.# <br /> Addroes f / 1`5 MC" �K�ULt lC— barr� �( f <br /> S V ,. lPhona/P-mail � 3 �+'✓Vf 1�� 0 Cra - <br /> t"NANT LSUSllNL3.5 NAME CONTACT FOR PERMIT <br /> Vq <br /> K'A T\-1 Y1�u;c <br /> Phone/L-melf <br /> gU1LDING PERMIT APPLICATION CONTRACT PRICE OF WORK Lbl" <br /> Existing Use of Building <br /> AT SOURCE; <br /> Proposed Use of <br /> Gas Electric Other <br /> Building type_ Ingle Famil `DuplexTownha Multi-Family _Commercial <br /> 01 <br /> T e of ry act; ew Addition Rarrlode Re e r Tl. 51 n S rinkler Demohtlon Chan o of Use <br /> DESCRIPTION OF WORK(pddlllonplsptao®provided or7 the aclQ: <br /> MECHANICAL PERMIT APPLICATION P U INC PERMIT APPLICATION <br /> Type of Project: —_New._fAdun _ glteratlon�Repair Type of Pro out. —Ne `Addn Alteration Rapal <br /> Show Ncrmbar # of frxtr/rgR Show Nu or � .____ <br /> A/C air handlln units of flxturas <br /> Forced airs stems lot <br /> Gas Piping Bat ub <br /> Water heater Lavat wash b@slrtY <br /> Gas fire <br /> Show <br /> lace v <br /> Galas range Kitchens k 8 osel <br /> C101hes dr er Dishwashe <br /> Ran a hood Clothes w r <br /> Exhaust Fran Water star <br /> Heat Pump Sink ervlce/bar o /eto. <br /> Unit haater Ba flow reyenter Inside bld <br /> golfer IT4 <br /> R®ftf oration I)rInking, Fountaln <br /> Woodstove Floor drain <br /> D jctln2 Grease arra <br /> Other Foot drains <br /> SPIYIN E Medical Gas <br /> RESS10 STEM Other <br /> um or of Heads <br /> Other: <br /> I hbroby oeltlfy that t have road and Isxamined this application and know the ealre to be true and coh®ot.All provisfons of lows end ordihance8 governing thle <br /> pwill <br /> with whetbor apeclffed herein or nt] 9 Aot,The ranting of a ermlt does not preeumo to give outhorlly to violate or cancel th® rovlhlon of en ourmr state or local lewra ulatlnk Wr ctlobo comp <br /> Thata <br /> l m aulhorizod by tIe owner of thle property to perForm the work For which eppllcgtlon Is mode and I comply w1th the State Controctoia t.aw 18.?.7 RCw and 296,200A w,AlG, n <br /> Owner/Aiathorfxed Aggrtt i9n3tur® / r <br /> Date <br /> (Revlaed 4/2015) <br />