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08/23/2017 WED 14: 39 FAX Fast water Heater 1003/008 <br /> I tg (/ - 5" <br /> PERMIT APPLICATION <br /> " BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> /__ rr CITY OF EVERETT PERMIT SERVICES <br /> 320a CEDAR S'i'REEf EVERETT,WA 98201 <br /> (P)423-257-81110 I FAK 425-257-8857 I(E)evarettopaGovarattwa-gov I www.everettwa.gov/permite <br /> Blue or Black Ink Oni Please PiROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: _5' . ; • ST Su PROPERTY TAX#: 1)02'1 OW_ WO <br /> LEGAL for new construction: Short Plat/subdivision Lot I . (attach copy of lang regal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: _SW/al* MCA .L iS T' TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS: srneaT _ j ' fl.F. "r A !(�y � <br /> CRY V L -+/ 's I BTATEzip ' t! b(-1 <br /> OWNER PHONE: Ir / 14 I ►'5 OWNER EMAIL: <br /> CONTRACTOR NAME; fA Si" vd Ai 14-5.-L "- k <br /> CONTRACTOR ADDRESS: STREET I\'-i'5 h) CA6p,ez_ � 1/44 S ff)(p <br /> ow L- -.. @Vox L A j k zip <br /> olg D <br /> iCONTRACTOR PHONE: (--1 5' to p CONTRACTOR EMAIL:P.Q,VY1 ,T S ( Sru)Ot,rT1Mor <br /> , (DV/ <br /> CONTRACTOR LICENSE#(REQUIRED): 4 Sl— "r ; sc., CITY OF EVERETT BUSINESS LICENSE it(REQUIRED) e 453 <br /> PRIMARY CONTACT: 0 OWNER t~ CONTRACTOR 0 OTHER(Please Specify) - <br /> CONTACT NAME: CONTACT PHONE: L(, de,L„, <br /> �" , <br /> K4� -^ '}l-.U" CONTACT EMAIL: �IN ,ft -PAS-311/3A.40,/1RQ <br /> DI- X, awl <br /> BUILDING PERMIT APPLICATION <br /> Exlstin! Use of Bulidin.: • r Contract Price of Work:$ <br /> Proposed Use of Bu(ding: 1 . Heat Source: ❑Gas alg6lactric ❑Other - <br /> Building Type: FR-Detached ©SFR-Attached I'Duplex DMultt-Family-#of Units_ _ - i_ICommerciai Olndusirial <br /> Type of Project: ONew ❑Addition ❑Remodel OltRepalr DTJ. 1=O5lgn ElSprinkter 0 Demolition C1Chsnge of Use <br /> DESCRIPTION OF WORK: •- <br /> fl Vno\I, hre,p\AL , C-ry 1 C )i —e \ACa-t-r <br /> ASSOCIATED BUILDING PERMIT#(IF appitoabie): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ow_ Addn ,_Alteration Rap r Type of Project: New ,-_ 1ddn —Alteration _Repair <br /> Flx#tures Ltd of Pbr7 : Fixtures °f Lfst of Fixtures °f List of Fixtures <br /> Rxturres Fixtures <br /> C—Alr Handling —t Pump - ---- ---- -Toile-- <br /> t Backflow Proventer(Inside Bids) <br /> orced Air Systems nit Heater Bathtub Urinal <br /> mad <br /> Piping Boller Lavatory(Wash Basin) Drinking Fountain - <br /> Water Heater Refrj9eratlon Shower _ Floor Drain <br /> Oas Fireplace '- - Wood Stove Kitchen Sink S.Disposal Grease Trap <br /> cea Range r ucting Dlshwasller Roof Drains <br /> oihes Dryer Hoo .e .. en Clothes Washer Medical Gas - <br /> R e Hood • Water Heater - Other: <br /> Exhslbst$a _ Sink(Service/Bar/Mop/etc.) Other: <br /> SPitit4 or, IPS E3SIOJSaVSTLM <br /> em12 or W ,of Heads - •• <br /> AC/WO WLEDGEM1 NT I have reviewed this application and confirm the 1nRmr% &ion contained herein la(rue end corned.Work done pursuant fo this pe-salt must comply wit» • <br /> current federal,st8114 and local law.The granting of a permit only authorizes approved work end no deviations therefrom.Davlations must first he suthorked in writing(Porn the <br /> Building Official baby being euthoiked under any circumstance.I am the owner,ori am authorized by the owner of this property to perforin the work for which application Is made, <br /> and 1 comply wIth the State Contractors.Low 10:27 RCW and 296.200A WAG <br /> Cily of Everett Official Liao Only ' <br /> . A,41 I t. I C 3</ 1 PERMIT# 1 <br /> Own' •uthorze. Ag. signature - - - Data (Revise. *2 1.11:) IL }vG (�1 ' <br />