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07/19/2016 TUE 11: 49 FAX Fast water Heater 0005/005 <br /> 4PERMIT APPLICATII L CP q uP Zl� <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-6857 wvvw.everettwa.org <br /> $IT AI70;L ` If_ PROPS _ TA O1 tD� 17#f.�' <br /> LEGAL for now construction- Short Plat/subdlvislon Lot No. (attach[copy of long legal description) <br /> OWNlwR D phone/E-mall <br /> Address 1" — L�3 _ A city/State/zip <br /> APPLICANT: Owner _Owner's Agent Contractor Contractor gAgent —Tenant (fro the onnar to do worn In the sesta) <br /> CONTRACTOR State LIC.# w �Clty Bus. Lic. <br /> l t N �~ <br /> Aaar®ss l �.KUULr S I,J r. l Phone/Small {�'3 IM / s <br /> TENANT BUSINESSAME CONTACT FOR PERMIT A-4-p- <br /> KAT-1 <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Exlsting Use of Buflding -AT SOURCE: <br /> Proposed Use of Gaa Electric Other <br /> Building type: Single Fa —Duplex_Townhouse Multi-Family „Commercfal <br /> T e o€ ro"ect: New Addition Remodel Re air 7.1. SI n S rinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additlona/space provldod on the leech) <br /> PAVV6 vt'/ r (a Com_ S <br /> . -.#-ter <br /> MECHANICAL, PERMIT APPLICATION PLUYWtNp PERMIT APPLICATION <br /> Type of pt oject: Now_Addn _Alteration__,Repglr Type of Pro] t: _New_ ld�n _Alteration_fZapalr <br /> Show Number # off Tures Show NumbA of fixtures <br /> A/C--air handlfnq units Tolle <br /> Forced airs stems Betht <br /> Gas pipinQ Lavato wash basin <br /> Water heater Shower <br /> Gas fireplace <br /> Gas range Kftchen s k&di asal <br /> Clothes dryer Dlshwash rClothes wa or <br /> Ran a hood Exhaust fan Water he e " <br /> Sinks vlce/ r/mo /etc, <br /> Meat um Unit heater Bac ow oreve er inside bid <br /> Ur al <br /> Boiler rinkin Fountain <br /> —Refrigeration Floor drain <br /> W oods Love Grease,trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> 3PRINK ER R�S$ION EM Other- <br /> Other <br /> therOther: <br /> I hemby oettlfy that I have road and oxamin®d this appllcalion ehd know the salne la bo true antl corroot.All pravlalonr or laws and ordinances governing lhla type or work Will be comp <br /> With whether spec1fled herwri or not.Tile granting of a permit does not presurge to give authority to violate or canoal the provialon or airy other state or local low rosulating canairuclfon <br /> That f am authorized py(he owner or this roperly to perform the work For which appllcatlon 19 made and I comply with the State Contractors Lew 1827 RCw and 296.200A WAC. <br /> MIA <br /> Owr,erl or zed Agent Signator J r ( - <br /> Date (Revised 4/2015) <br />