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12/2$/2016 WED 10: 44 FAX Fast ter Heater U003/005 <br /> RnnrTAPPLICATION" . <br /> L.1 q 5 .- <br /> BUIL.DING/MECHANICAL,/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 95201 425-257-8810 FAX 425.257-6857 www.everettwa.org <br /> SITE ADDRESS: f JO <br /> t n` <1 _ ' PROPERTY TA # <br /> PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision - Lot No- _ (attach copy of Tong legal description) , <br /> OWNER / ' ( <br /> � <br /> LIN PhOns/E-mall "t v,.5-q53 61�341 <br /> Address i 6 � IQ p ,� 3'� 1� <br /> City/State/Zip V e-re , w 19-- 9g, , <br /> APPLICANT: Owners Owner's Agent Contractor ^,Contractor's Agent _Tenant(must provide a Whet ot�noBnl from the owner to do work In the apace) <br /> rN3� <br /> CONTRACTOR • ,. a . : .•/ i,' 4 o tate Llc.#$ <br /> AA�� ,N AAA)�" � 's ICy Bus.LiC- •`"I1yd <br /> Address ( 1 I� �P VuW C~ P 1p Ira i i <br /> r , "`..I ' hisi.. Phone/Emell 49c i 3 ! L• 'q1' 114,+5 0i frt <br /> ERMINE NAM CONTACT FOR PERMIT IT C •v-. <br /> Phone/E-mall , , , [O >r ,{ (.- -4P-r-tt9ttILAiei-k-44ter <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OP WORK <br /> Existing Use of Buildingir <br /> HEAT SOURCE: <br /> Proposed Use of e F Gae_� Electric Other <br /> Building type: Al' Ingle Femil Duplex Townh. :: _ Multi-Family Commercial <br /> T •e of.ro ect: New ._ Addition Remodel! • <br /> T.I- Sl�n S S.rinklsr Demolition • Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the-beck): <br /> •gehm‘rerilirtpkek Lk_ .______, ...1, ii6N-tir. kiwo-c4--- <br /> MECHANICAL PERMIT APPLICATION f PLUMBING PERMIT APPLICATION <br /> AMMMMOV <br /> TYof Project: _^New4ddn _Alteration Repair Type of Project: <br /> TAXI _ <br /> ew _Addn <br /> Show Number ,. of fixtutea _Alteration R-•air <br /> Show Number • of fixtureseratiOn <br /> 111111.1111 A/C–air handlin• units Toilet <br /> Forced air systems___ �\ Bathtub <br /> Gas p ping _ <br /> Water heater► Levet° wash •:ein) <br /> Mk Gas L_Shower <br /> 1111 <br /> Gas range & t Iapoetal <br /> Clothes dr erg Dish er <br /> Clot a hood -- � lot.= <br /> Glots washer <br /> Exhaust fan � .alter heater <br /> Heat pump servlce/ber/mop/etc.) <br /> _ Unit heater w .reventer Insld®bid. <br /> Boiler Drinkln. ountaln <br /> Refrl111 <br /> eg ration — I ^. <br /> Woodstvve �� Floor dram <br /> Gre <br /> Ductln. —" iaS®�tra+ <br /> 11111=11.111Other \ Roof drains <br /> --- Medical Gas <br /> SPRINKLER (SUPPRESSION - STEM _ — <br /> Other: <br /> •. - _ of He .. <br /> ._ Other: <br /> I hereby oelllfy that I have Ned end examined this application and know the sane to be true anti oon act.Al provisions of laws and ordinances governing this type of work will be comp <br /> with whether tweeted herein or not.The granting of a permit does not presume to give authority to violate or canoe)the provlllon or any other state or iooal law regulating canalruC(lon <br /> That I am uthor .d by the owner. this property to perform the work ror I lah a lloation,le made end I <br /> - � - - ,.- • --- : ...-.,. ppComply with the State Contractors law 19.27 RCw and 205.200A WAC <br /> bAl i •4) <br /> owner/Ata f'. ': -astir Signa urs / " <br /> Dat® <br /> (Revised 4/2015) <br />