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Jul 09 2019 10:52AM Washington Water inters 8663757454 page <br /> WI PERMIT APPLICATION <br /> BUILDING/MECHANICAL I PLUMBING/SIGN/SPRINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> WASHINGTON320(P)425-257-8810 I FAX 425-257-8857 0CEDAR STREET,TEVERETT,WA 98201 <br /> per, S( 1( )averettepc®evonaHwa.goa I www.averettwa.gov/permits <br /> Inn On _,Please) PROJECT SITE.INFORMATION <br /> PROJECT SITE ADDRESS:1600 121ST ST SE, UNIT A104 • <br /> LEGAL for new construction: Short Plat/subdivision PROPERTY TAX :00837500110400 <br /> Lot No, (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> • <br /> OWNER NAME: MELSETH, BRITTANY <br /> OWNER MAILING ADDRESS: sTReET 1600 121ST ST SE, UNIT A104 TENANT <br /> BUSINESS NAME(Commercial): <br /> cm EVERETT <br /> OWNER PHONE: 425-760-7974 scare WA zip 98208 <br /> OWNER EMAIL: <br /> CONTRACTOR NAME:WASHINGTON WATER HEATERS <br /> CONTRACTOR ADDRESS: sTREEr 17152 116TH AVE SE PO BOX 59208 <br /> err, RENTON <br /> CONTRACTOR PHONE:425-883-4871 STATE WA Zip 98058 <br /> CONTRACTOR EMAIL:WAWAHVAC@GMAIL.COM <br /> CONTRACTOR LICENSE#(REQUIRED):WASHII"9800P !CITY OF EVERETT BUSINESS LICENSE fi(REQUIRED): 053449 <br /> 'PRIMARY CONTACT: ❑OWNER D CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE:425-883-4871 <br /> JACCI DANIELS CONTACT EMAIL:WAWAHVAC@GMAILCOM <br /> BUILDING INFORMATION <br /> Existing Use of Building:RESIDENTIAL •• <br /> Contract Price of Work:$1400 <br /> Proposed Use of Building: <br /> Heat Source: (]Gas DElectric DOther <br /> BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ASU ©Multi-Family-#Units:1 ❑Commercial ❑Accessory Struc 1r <br /> T .e of Proect: ONew ❑Addition ❑Remodel OR--.air ❑T.I. ❑Si•n DS•rinkler ❑Demolition ❑Chan•e of Us= <br /> DESCRIPTION OF WORK: REMOVE&REPLACE 1 GAS WATER HEATER �r I « f <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> • MECHANICAL PERMIT APPLICATION <br /> F7,lu,s PLUMBING PERMIT APPLICATION <br /> Count list of Fixtures �"tvre List of Fixtures Fixture ' <br /> Conor Count List of Fixtures Fixture <br /> NC—Air Handling Units Count List of Fixtures <br /> Gas Piping Backflow Preventer(Inside Bldg) _Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-ResidentialSink-Commercial itchen,bath, ,fl,) <br /> Duct System(Remodel) Refrigeration Orinking Fountain u (k,tmop,bath,bar) <br /> Exhaust Fans Residential Commercial VentilatiorSoileUtility,laundry,mop <br /> Exhaust Hood(Type I) Hose Drain Trilet <br /> Exhaust Hood(Type II) (Not Heat/AC system) Bibb Urinal <br /> 1 Water Heater Interceptor-Grease <br /> Exhaust Hood(Residential) Wood Stove Waste/Water Piping Repair <br /> Interceptor-Sand/011 Sand/011 Water Service(hehinc meter) <br /> Forced Air Systems Other. In <br /> Gas Fireplace/Insert/Log Medical Gas Water Valves or Fixtures <br /> Roof Drains Water Heater <br /> SPRINKLER I SUPPRESSION SYSTEM _ <br /> Water Suppression System Seurage Ejector or Sump pump Other: <br /> Chemical Suppression System No.of Heads <br /> �No,of Heads <br /> ACKNOWLEDGEMENT l have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> current federal,state,and local law The granting of permit only authorizes approved <br /> Building Official before being authorized under anyC1rc fence.1amthe ownrIamauthr�edbVtheoWtnerofthy' ropeytomustmstbearkfozwdc applcironthe <br /> and l comply with the State Contractors Law 18.27 RC nd 296200A WAC y property M pertain the work for which application is made, <br /> r <br /> Lail <br /> City of Everett Official Use Only <br /> PERMhT/�/� /� <br /> •W riAutherized Agent Signature 7)9)19 t� 1 ,� On <br /> ��I /, <br /> Date (Revised 10!10/2018) l L/n <br />