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08/23/2016 TUE 10: 00 FAX Fas water Heater phi la003/005 <br /> •ERMIT APPLICAT1Olt <br /> 0"g10 <br /> BUILDING/MECHANICAL,/PLUWIBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evorettwa.org <br /> SITE AD•RE'"• L PR•PERTV • <br /> LEGAL for new construction: Short Plat/subdIvlslon - Lot No. (attach copy of long legal description) <br /> OWNERp[^^ 0 f1` S P P Phone/E-mall v . B li <br /> Address W/tt S I 2t 0/ City/State/Zip - • M A •' - A 3. <br /> APPLICANT: Owner Owner's Agent Contractor `Contractor's Agent Tenant(must provide a utter of consent from the owner to do work In Ina apace) <br /> CONTRACTOR ���J. A ' 'a. 'golf- ' State Lfc.# .4,104 <br /> ��_ .A WW k-'# T ,Cit Bus.Lie. • <br /> Address et M E Hata[ WA. Phone/Email .49S-123 • it. tfj' tTh 17`.5 t A j -h$ <br /> ENAN- SINESS AME CONTACT FOR PERMIT rT '..C,yy1 <br /> phone/E-mall . •I, , l► awl ,0.1.0 1r A✓ 'P" <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK nit la <br /> Vilm•Existing Use of Building HEAT SOURCE; - •�� <br /> Proposed Use of B • • <br /> •' Gas , Electric Other <br /> Building type: ♦ ingle Famil Duplex Townhouse _Multi-Family _Commercial • <br /> T .e of•roact: New Addition Remodel G•.."e,a 1.1. Sion S•rinklor Demolition • Chane of Use <br /> DESCRIPTION OF WORK(sdd/tdonsl space prodded on�ck`J: <br /> A <br /> 1PAPAA• <br /> 4 trtp lex c-it- ____4Afr.-±__., 11)1/44.4eAr 6/00-e4-- <br /> • <br /> MECHANICAL PERMIT APPLICATION <br /> L PLUMBING PERMIT gPPLICATI N <br /> Type of ProJoct: __NewYAddn _,Alteration_Repair Typo of Projec Ne -ddn _Alteration—Re Ir <br /> Show Number . of f/xturas Shaw Num,erjlitof fIxfures <br /> A/C--air handlln. units To et <br /> - <br /> NM <br /> Forced air s stemsI Bat'.ub <br /> Gas thin• - <br /> DJ water heater Lava •ry(wash ba <br /> Show; <br /> •1111Gas fire.lece 1116.•111.2121=177.Is•osal <br /> miDas range Dlshwas e- <br /> Clothes dryer Clothes :sher <br /> Range hood Water ea or <br /> Exhaust fan <br /> Heat 'urn. "— Sin..4servl.=/barlmop/etc.) <br /> Unit heater R-ckflow pr:venter(inside bldg) <br /> Boiler rival - <br /> Refrigeration Drinkin• Foun i:ln <br /> Woodstove Floor drain <br /> Ducting Grease trap ` <br /> OOther .i Roof drains <br /> 111W– <br /> SPRINKLER Medical Gas <br /> .4;;��RESSIO> :YSTEM !Pr Other: <br /> Number• --"� - ..-- <br /> Other: <br /> I hereby gertlfy that I have reed end examined this application and know the Same to be true and correct.All provisions of laws and ordtnencea governing Ulla type of work will be comp <br /> with whether specified herein or not,The granting of a permit does not presume to give authority to violate or cancel the provikbn of any other stale or local law regulating construction <br /> That I am authoriz=e by the owner of(hi: .roperty to parrorm the worn for which application is made end I comply with the Slate Contractors Law 16.27 RCw and 206.200A WAC. <br /> cAAk , .• 1 . ' /33-- <br /> ce„ <br /> Owner/A f` "'=• Agent S Tnature <br /> Date (Pev/sed 4/2015) <br />