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02/10/2017 FRI 12: 25 FAx Faet water Heater f�0p6/003 <br /> �'E�RNII�T' A�+P�.��A1�`i� � �I�D�O _ <br /> F,3U1[�DING�IVI�CH,A,NI+G,AL/PLUM�3�Nt�,/SIGN6�PI��NI�I�E�/1]�M�L.I'i''I�N <br /> CiTY O� EV�RETT pERMIT SERVICES <br /> 3200 Cedar St., �vera{t, WA 98201 425�257-8810 f=,NC 425-257-8857 www,everettwa.org <br /> SITE ADDR S�: d r��� r � PR T X� p M , <br /> � ' � D OD y � � p2� ���.�:,�, <br /> �-�GAL..For nevd conalrUctlon: Sholt Pl�t/subdlvfslon Lat No_ (sttach copy o11or1g lag�l descrlptlon) <br /> OWN�fi `�i{� ( phone/�-rtratl oC.� � <br /> Addreas a �� S � Gly/9tate/Zip ��, �� g� <br /> APPl.ICAN`f':_owner _Owner's qyent COI1ff�Ctor �COntr�CfOf 9 AgBFIt �Tenflnt�mual Drowtle e Ietter cf canaanl from lh�o4vrqr tv da wo�k m IRa epecq) <br /> CONTRACTOR '� ��- 5tate LiC.# �/U�p,) U ��Clt BUS,LIC. '� <br /> Addreea � �' � � � ���/UL� S ��— b� � <br /> E FJUSIPJESS AM� �I • Phane(Email ��(tr3 1`�� ,� -� <br /> CONTAC-I'FOR P�FtMIT �.e,r,� <br /> . `�v �� 1��i��/� <br /> PhonelE-mall . � � <br /> B[y��,D��1G PE�MIY ,AppLICAY'1(��1 coNTiz4CT�F2�CE or-woRK -- " �" <br /> �xlafing Use of guflding HE,qT S RCE, <br /> Progosed Use of�uliding ,Y� r <br /> Gqe E ctrl Other <br /> Building type: _____Single Famlly �tiuplex_Townhouae ultl-Fam, Commercla! <br /> T e of ro ecE: New Addi#foi� Remo sl Re a r.l. Si n S rfnkler pamoiltlon • Chan e of Use <br /> ��SCRIP'TION OF WORK�gdd;rronei s�a��,oroYrdea or, e beck): <br /> ���`�r �� c=.�. -�I-� �1�-r��� <br /> �P , �.� ���- <br /> N�EGH4�ICAL PERMMT APPl�1�AY'IpN PLUMBI�IO PERMIT ltPPLlCATION <br /> Type of Profacf: ____New ddn �Altaratlon�Repplr Type oP proJect: �Na�,�r ddn <br /> Shpw ber o fxturas —f� �Itaratlon_Rap��r <br /> A/C,alr h dlln units SHow Alum6er � or�ixeures <br /> Forced 81r s tems �ollot <br /> Gae f In �afhtub <br /> Water heeter ����Eo Wash basfn <br /> �ag�� ��Ge Showor <br /> Oa� ran e Kitchen slnk& Is osal <br /> Clothes dr er Dlshwasher <br /> Ran e hoo Clokhes washer <br /> �xhausC n �18fer heater <br /> HeSt m 5111k se�vlce/bArlmo /etc. <br /> Unl eater Baakflow revenfer Inslde bld <br /> Iler Urinal � <br /> R�frl er�tlon nrinkln Fc�untafn <br /> Woodstvv� Floor draln <br /> Ductln , Greaee��tta <br /> Other Raof dralns <br /> SPRINK R ! S �g�rp{q Medlcel p�s <br /> M dther: <br /> ro eads <br /> , Other: <br /> heraby agh�(y Yhet I F�eva�ad and examined thla applloatlon pnd khoW ihe aeme to be frUe and oohect.All provlslone aF��+,ye and ofdinencgg�oveming thla rype of Vvorlc wlll be nomd <br /> wlEh whather epeclAea h�reln or na.The g��nting ol a varmlt�loga not preaume to glve authan�y la vlolafs o�cancel tne pmvl�lpn of any alhmr etate or locel lsw regulsling rqn���cilon <br /> fhAl 1 em authanZed by the awnar oF t la property lo pe�arm lhe yvark For whlch applfp���on fa mqde end I comply wl�h�e 3tete i;onlrectore I�a+N 78,27 F2CW pnd 298.200A wqC. <br /> �wnar/quth ag�np 9lgnae re l� � J I � <br /> Dai� <br /> (R�v13sd 4/2096J <br />