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02/25/2017 SAT 12: 57 FAX Feat water Heater U004/004 <br /> •ERMIT APPLICATEc 1 r-._. ) ._,L,_ <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425.257-8810 PAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: Z J'') h u Scf'f V �� P P TY TAX; ' <br /> t" V PER � • <br /> [1,11100 ft)1 102.' O(o o <br /> LEGAL for new construction: Short Plat/subdivision Lot Na. <br /> (attach copy of long legal description) <br /> OWNER f'e 1�• e. C .e.. <br /> Phon®/E-mall a �T <br /> Address SS IPCity/Stat®/zip sg J ' I rJ b I <br /> APPLICANT;._Owner Owner's Agent _ Contractor Contractor's Agent —Tenant(must provide a letter of consent from the owner to do work In the apace) <br /> CONTRACTOR " (1 l •(/( I �- �i State Lic.# •,1, '/'.J J k • 1' Cit Bus.LIG. - b-�•�•••.•• <br /> i 1 fie '1 .vo, l ir-y 7 e <br /> Address „ ( , Phone/Email <br /> ENAN 1 SI ESS •ME y 9 (3 ' et t!i" 147.5 r 1 • <br /> CONTACT FOR PERMIT 1'r A -r, <br /> yll <br /> Phone/E••meli _ Ar, ;, 0.. Yr . (. 1►-y.rt. iLi...t.ev A d <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building EATS V <br /> ..;; SOURCE: <br /> Proposed Use of : ' 1114.• ___ - ---• 1—M Electric,._ Other <br /> Building type: il Single Family Duplex Townho Multi-Family � <br /> -' Commercial .• <br /> T ee of era ect: _ New Addition Remodel a• T.I. Sinn S.rinkler . Oemolltlon • Chan,e of Use <br /> DESCRIPTION OP WORK(additional space provided errs .mac <br /> .gitionat4re,pkek c s <br /> MECHANICAL PERMIT APPLICATION 43212 IN© PERMIT APPLICATION <br /> Typo of Project: New Addn __Alteration_Repair <br /> Type of Project: _,.N,• /lddn Alteration_Ropglr <br /> Show Number of fixtures Show N • her(#J of fixtures _ <br /> 1111111111111. NO--alr handline units eller <br /> 1111111111111 Farted airs stems B-thtub <br /> 111111114111111 Gas •I•In• MinelliEncto wash basin <br /> raiiiii1M. Water heater <br /> Gas lire lace -- $h• ,_r <br /> Gas ran•® �— Kitche sink&di.-•osal <br /> 1111111111111Clothes d er �— Dlshwa:.er <br /> Ran s e hood �— Clothes w. or 71 <br /> Exhaust fan Water he- <br /> Heat um Sink s-, i.,arerne./etc. "-" <br /> MI <br /> Unit heater Ba •ow prove ter(inside bide) <br /> Boller U al <br /> Reffis oration - ro rink Fountain <br /> Woodstove Floor drain ""' <br /> Ductln. = <br /> Roof drains <br /> Other_S �MMedical Gas <br /> PR1 / SUPPRESSION TEM = Other: <br /> Number <br /> Other <br /> I hereby Oerafy that I have read and trxam(nad this appfoatloh and know the same to be true end cement.Ali provisions of(ewe end ordinances governing this <br /> type with whether specified herein or not.The granting of is permit dost}not presume to give thorn to violate or cancel the rovlbion of an other State or local law re ou( hk col stbjolonot(an <br /> The(I em auth•. zed by the own<rof thie•rop•rty to perform the work for which application(e made and i comply with the State Contractors Law 15.27 ROW antl 295.200g A WAC. <br /> Th <br /> )wnerl• ho' ed Agent Stgnatur- date 1 <br /> (Revised 9/2096) <br />