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02/20/2017 MON 14: 05 FAX Fast water Heater fJ005/005 <br /> 'ERM1'T' APPLICATI 'S(-4 2-1 - <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMGLITIDN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425257-8810 FAX 425-257-8857 www.everettwa.org <br /> • <br /> SITE ADDRES ' / ' ! V e. 0 PRO,. . 4,T, it P T ""'�! <br /> r . , , Ob 3 ._1000 PMTi2— OS l— <br /> LEGAL For new construction: Short Plat/subdivision Lot No. <br /> /� (attach copy of long legal description) <br /> OWNER 011 yr��1/1 t ( 1 <br /> ( Phone/E-mall .�• .1 0 <br /> Address '4" � . <br /> a �j S e /D.City/State/Zip fjV' e-H- A e 1 /av' <br /> APPLICANT; Owner Owner's Agent Contractor Coae Contractor's Agent Tenant!moat provide a lefts,of conavnl from lila owns,to do worn In Iia apeca) <br /> CONTRACTOR RACTOR A `1' \L. A g - 1 -" 1 State Lic.* A V JW f--o ...-.�.., <br /> ,Cit Bus. Lic-# <br /> j ! I . C-- : , • n1 1 <br /> Address ,ktAm S hone/Email Jr <br /> �i` po��(G , y 4,..4.- 04l 1'� ?til wt�e <br /> TENA igINESS NAME <br /> CONTACT FOR PERMIT Iri cn-fC°',Cyyl <br /> Phone/E-mall . ii, ,, ►.1. L allf' 1 I e4 ./ '(r <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ' % .6x% <br /> Existing Use of Building `i r — y <br /> 'nn HEATS E: <br /> Proposed Use of Building ( V' j7 ° <br /> Gas 41P)N other <br /> Building type: Single Fancily ,Duplex Town u P Multi-Famli Commercial <br /> T .co of•ro ect: New Addition Remodel left -T,I. Sin S rinkier Demolition • Change of Use <br /> DESCRIPTION C)F WORK(additional specie provkiod on tho bock).: <br /> P ® ript',i U__ 'A ).0 wct,i-vr- kico-e4----. <br /> MECHANICAL PERMIT APPLICATION <br /> CPLUMBING PERMIT APPLICATION <br /> T/p0 of Project: �{�Quc,-- ddn"" glteraYlon, Repair <br /> Type of Project: Now Atkin Alteration Repair <br /> dhow Number 1115 of fixtures <br /> Show Number rb off/xturga <br /> A/C—air handling units ToiletIral "" <br /> Forced air systems Bathtub <br /> Gas piping _ • Lavatory(wash basin) <br /> Water heater Shower <br /> — <br /> Oas fireplace Kitchen sink&rllsposal <br /> Gas renoe ��~ Dlahwesher <br /> Clothes dr or Clothes washer <br /> - Range hood 11.11.1 Water heater <br /> Exhaust <br /> Heat�u fanmp Sink servIce/bar/mo /etc. <br /> Unit heater ,./ -�- Backflow preventer(inside bldg) <br /> 11.= _ Boiler — Urinal <br /> II, Boiler tion --- brinkln Fountain <br /> 111\. Wpodstove ----- - Moor drain <br /> �_ Hucfing Grease'tra• <br /> � <br /> Ot.e, _ - . Roof drains _ <br /> SPRINKLER / SU ESSION SYSTEM — Other:Medical Gas - <br /> — Other; <br /> Number of H® T Other: <br /> I herAb �' <br /> y nehlry That I have reed and examined thla application and know the earns to be true end correct.Ail provisions of Tawe and ordinance.governing this type or work will ba comp <br /> with who her epeolfiod herein or not.The granting of et penult Hoes not presume to give authority to vloiete or ounce]the provihlon of any other slate or local few reguletng conayuctIon <br /> That I am ut prized by the ow dr of this property to perform the Work For whloh appiloation la made and I comply with the Stats Contractor Law 18.271-40N end 296,200A WAC. <br /> Jwner/Authorized Agent Signe're Date <br /> (Ravieud 4/2015) <br />