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01/27/2017 FR= 7: 58 FAx Faet water Heater I�pp3/OOa <br /> _,, . . <br /> l�MIT �4P�'�I�A'�I��� � ���C.p�. .... <br /> BUILDIN�/M�CHANICAl../PLUMBIN�/SICN/SPt��NKL�RlDEM�LI�"�UIU <br /> GITY OF E'V���TT PERMIT SERVIGES <br /> 3200 Cedar St., Everett, WA 98201 425�257-8810 FAX 4�5-257-8857 www.everettwa.org <br /> SITE�1DDI�� S� � ' PROPE f tF PERMI?# <br /> ST � � D <br /> L�OAL for new cOngtructlon; 8hort Plat/Bubdivialon Lot Pla. (ettaCh copy of long Iggai desot(ptlon) <br /> OWPIER � L I�hone/E-mall � �— �� � <br /> Address a C I-�' � �J �"]— C�tylSt�telZip <br /> 7 <br /> APPLICA�"�;_Owr16r ,,,_Ow+'+er's Age11t Co�ttrsctor ^Contrector's Agent �T8Rq17t(muaf provhle a le{��o�coneent from Ihe owne�ta Qo wcrft�1 ihe epa09) <br /> CONTRAC�'OR � � State LIc.# � ���- g�It Bus, Lia � <br /> Address l C'"/ � � �'�' ���/UL1 S ( ( L <br /> - t� <br /> �J' �• t�hcne/Emall o� (d� YV1 I'I� � � "� <br /> 'fENA U91NES NAME GQNTACT FQFt pERMi"� � v-, <br /> - ���1 ���l��- <br /> Phone/E-maA �, �, <br /> BUILDING PERIYI�T pppL�CqT10N coN7�cr Pwce or-wORK �'" <br /> Exlsting Use of 6ullding EAT SOvRCE: <br /> Propoaect Use o din Gas� Electrlc Olher <br /> Building type. Singla�'arrtlly Duplex_,.,,Townho Muftf�Femily _Commero�al <br /> T e of ro ect� e �ddition F2�mode F2e T.I. S( » S rinklar Demolition • Chan e of Use <br /> DESCFCIPTION O�WORK(edd11lona!spece provlded on the b�ck): <br /> , <br /> ����� �� � C s � � . <br /> � . �.� �.��-- <br /> MECHANIC4L PERMIT APPLICqTlON P4UM�IINC� PERMIT/kPp►L�CATION <br /> type ot ProJact: �Naw_p�d�n _�ftar�tion_liepair Type of proJec• �kew qddn �,Aikarqilon,_„_Repelr ' <br /> 8how Numbar of fIxluras Shaw Numbe p/1/xluras <br /> A/C�air handlln unita Tollet <br /> 1=oroed�ir s stems Bathtu <br /> Gas i In . L.�vato wash basih <br /> �Nater heaker Shower <br /> Qas ftre lace Kftchen sin &d�s a� <br /> Qas ran e Dlehwasher <br /> Glothea dr er Clothes was <br /> Ran s hood Water heat <br /> Exhauet fan 51�k ser celb r/mo 1etc, <br /> Heat um �acktl reve ter inside bfd <br /> Unit heater Urin ' <br /> Boller D kln �Quntal <br /> RefH eretlon Ioor dwain ,• <br /> Woodstove <br /> Dlrctin , Grease�era <br /> Other Roof dralns <br /> �P�� Medlcal Gas <br /> �SSIO T-�WI Other: <br /> - � eade <br /> Other: <br /> ��ara�bY vert�fy tMat I heve remd and 8�amined thle app�lvatlon and know the same lo be true and oortr,dG A{I proVlslona pf 18W8 and orClnbhcea gov�min��►g tyPe Q{�,ya�k WIII be CCmp <br /> WIFh whether 9paalffed herpin or noG The granllnp of e perm�t daes not p��yume lo glve aulhohty lo vlola6a a�cancel the pro�l�ian pl ttRy olher sSp�a ar local law regUlelifhg conetruotfon <br /> TFt I�am autliorized by tho wner o!lh�a vropeyy to perPorrr�lhe work Iy�whlah epplfGe�Hon le m�de and I cornpfy wllh thq Stafe Conk�Ctors!aw 19.27 RCW end 295.200A WAC- <br /> i - .._ <br /> Ow rlauthorfsa goni Sig ature ✓ pnt0 <br /> � '�� � O� ( v/aed d/2016) <br />