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05/11/2016 ATED 8: 3$ FAX FaSt A7at0Y Heater_______ ___'_____ ��__ �004/005 <br /> ...... . . . . , , <br /> �'ERMI'1" APpL�����'� g.$ . .. <br /> BUILDING/MECFIANICA�,/pLUM�ING/SICN/SPFtINf�L�R/D�NVIC?L.IfiI�N <br /> CITY QF EVERETT PERMIT S�RVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 �AX 425,257�8857 www.everetfw�.org <br /> SIT�AD RE$ : �y�`fi{� ��� PROPERTY TAx# <br /> . �� �- S�� DD ! 8D �� �z �O <br /> LEGAL for new canatruction: 8hon p�at/subdlvlsfpn Lot No. (attach copy af lonp legal deserlpUon) <br /> OWly�R K�� �U�� �� phonelE-maq �I�S "J� 1� <br /> Addrass ��' ��f L ��. Clfy/State/Zip � �'j ��- �'g� <br /> �APPLICANT:_Owner _OwneTa/{qent �Coflfl'8Ct0� _CGf1tfSCfONgAg9llt _T�ftpnf(mus[D�av�aeeteKvrafconssnlfroml�eownertodowo��nt�eapaoa) <br /> CONTfiACTOR • �1 � •� �,q� sc�t�uo,# WW �'�.c;� eu9.u�. <br /> Acldress � I, I 1�1 � �yU�'� �� � � { <br /> S (Q, �Aj • Phone/Emall a��3 r'�",,S -}� <br /> A BUSINES AME CONTACT FO(�PHRMIT ,rn r. yy) <br /> ��� ��V� <br /> Phone/E-m�ll � �, <br /> BU�LDING PLRMIT dPPLIC�►TI(�I�A CONTRqCT PRICE O�WORK ���' <br /> �xisting Use of�ullding H�AT SOURCE <br /> PropoSed Use oi B pas Electr�c �Iher <br /> Bullding typQ_ � In la Farnif �_DuplQx Townhouse Multi-Fam!!y ��or������� <br /> T e af ro'ect: New Additfor► Remodei Re aIr T.I, Si n S rinkler Demoliilon � Chan � of�lse <br /> DESCRlPTION 4F WORK(addi(ronel space prov�ited on!he dac�: <br /> ����� �e� C.�.. s .,� � � �.r��r�- <br /> � ��� <br /> MECN4N�CAL P�R{Il11�'oPPLICAT1oN PLUMBINO PERMIT APPLICd�ION <br /> l�rp�ot Pro�act: �New_Addn ��1ltsratfon�Ropalr Type f Pr ect: _IVew_qd�� _�{taratlon�,Rapatr <br /> ShowNumbar oYHxEurgs Si►owNumbsr # of//xtur�s <br /> A/C—air handllro unit$ Tollet <br /> Forced 2ir s steme - - --- - - - Bathtub <br /> Gas I in Lavato wash basin <br /> Water hast�r Shawer <br /> Gas flre lace itchen sink&dis sa! <br /> Qas ran e <br /> Glo#has dr er �i washer <br /> Clvt s waa r <br /> Ran e hood Water r ' <br /> Exh�ust fan Sink s e/bar/m'v /et�. <br /> Heat um Bac ow r enter inside bid <br /> Unit heator al <br /> Boller rEnkln �ountafn <br /> _. _ _ . <br /> Refrl eration Ffaor drain <br /> W oodstove Grease�tr� <br /> Ductln Roof drains <br /> Other Msdlcal Gas <br /> SP KLER / �IIPPRE other: <br /> Number of Neada Other; <br /> I ha�eby certlPy tY��ql�hm4e read and examined thls enplloailon ana know tl�e same ro be Irue and correct.qll proviebne o�IaWS and ordlnenCeB BOVerhlnp thls lype�work WIU b�comp <br /> wlth whem@r 9p�Qi�ed hereln 0�nvt,The grentihp of a permit�aes nOt presume lo qlvo euthorlty!o vlol�ta or cenCei th9 prpvlefon of any ol„�P xte�tv or local iew regvfplfn�aonstrucllon <br /> That 1 am authurized by lhe ow er oF thle propeily to perParm tnp Work far whlch 1Wplioatkon Is me�Jp and�aomply aqtN It��,State Qontractors�aw 18,29 FCW anU Y86.200A WAC. <br /> ♦ . : _.,. � �. , ;. ; , :� <br /> 5 11 -1 (v <br /> Own r u e�nt S gnature Date <br /> (Rev/sed 4/z045) <br />