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NM PERMIT APPLICATION <br /> Eli <br /> BUILDING / MECHANICAL I PLUMBING I SIGN /SPRINKLER I DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHI NGTON PI( 425-2574810 I FAX 425-2574857 I(E)eyeretteps(Povorottwamov 1 www.evereltwa.poviperrnits <br /> ... <br /> Moe ow Mack Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:1720 124TH PL SE PROPERTY TAX#.! <br /> LEGAL tot how Lonstruction: Short PlaLisubdivision Lot No attach copy of long legal description) <br /> CONTACT INFORMATION <br /> : . <br /> OWNER NAME WILLIAM DOWSING -TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: El HEFT 1720 124TH PL SE <br /> ow EVERE/ I STATF WA z'98208 <br /> OWNER PHONE:2069027842 OWNER EMAIL:DOWSING8@GMAIL,COM <br /> CONTRACTOR NAME: BLUE FLAME HEATING AND AIR <br /> CONTRACTOR ADDRESS: •STREET 7116 220TH ST SW#1 <br /> cry MOUNTLAKE TERRACE ,:lAIL WA ".. 98O43 <br /> CONTRACTOR PHONE:4257717139 JCONTRACTOR EMAIL;INFO@BLUEFLAMECOMFORT.COM <br /> CONTRACTOR LICENSE#1REou1R5D);BLUEFF825RM CITY OF EVERETT BUSINESS LICENSE CREQUIRED): 60435 <br /> PRIMARY CONTACT: 0 OWNER a CONTRACTOR El OTHER(Please Specify)_ ,....._ _ <br /> CONTACT NAME: CONTACT pHoNE:4257717139 <br /> BLUEFLAME HEATING AND AIR CONTACT EMAIL:INFO@BLUEFLAMEC ONIFORT,COM <br /> s <br /> BUILDING INFORMATION <br /> ....wk <br /> Existing Use of Building: Contract Price of Work:$ t1450 <br /> .... <br /> Proposed Use of Building: Heat Source: taGaa 0Electric, Dottier <br /> BUILDING USE: OSER LITowohouso F1Duplax FIADIJ ElMulti-Farrilly-If Units: OComrnerbial DAccessery Structure <br /> REF of Protect EINovir ElAdditloti 11'emodel Dfiepair DTA. OSign 06pr:inkier EDeracilition EIChange of Uso <br /> DESCRIPTION OF WORK: <br /> u -4 ox d V-.1nd .311)Y via ce 5v3c,te. ard ck.c. untsfal <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMING PERMIT APPLICATION <br /> — . <br /> Fix hire Fixture Fixture Fixture <br /> List of Fixtures L f is f oFixtures List of FiXtUreS List of Fixtures <br /> Count Come COMM` Count <br /> 1 NC–Age Handlir9 Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Batter Gas Range Clothes Washer Slok-Commercial(3-comp,prepfloor) <br /> Clothes Dryer Heat Ponip&Ductioss Dishwasher Sink.Residential(iolchen,batli,her) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Vuntilutleir Hoot Drain Toilet <br /> Exhaust Hood(Type I) rNot Heal/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Hooter Int urcoplor-Grease WastelWater Piping Repair <br /> ----- <br /> Exhaust HOW(ROSItiehttet) Wood Stove Interceptor-Send/Oil Water Seurksi(behind Muter) <br /> I Forced Air systsins Other: Medical Gas Water Wiles or Fixtures <br /> Gi19 FirepineeilRSOITIOg Root Drains Writer Heater <br /> .SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other <br /> ...._ <br /> Water&tparession 4stom No.of Hearts <br /> trie7-1nica Su ppressinn System No.of Heads <br /> ACKNOWLEDGEMENT:!have fevieWeei MIR appIlcetbl z4nd ctirdirrn the 111101Milfrati CriffiilitVd heroin is true and correct.Work done.pursuant to Ws permit must comply with <br /> current federal',stare,and loail taw The granting ole permit why lialhorizcs approved ir-erk and no delqatierts therefrom Deviations must first be Righeriied in whir from the <br /> Boating Official'before bekxj 4111110117ild ender epy orrournstonco.I em the wirier,or I em authorized by the owner of Ws properryrc perform the atenrk for which,-i.Anitastion Is made, <br /> and I mpity with the atate COntractntS Low 10.27 ROW and 21J6.200A WAG. <br /> City of Everett Official Use Only <br /> 1 <br /> "---- ,–,'V <br /> PERM( oc.;\0 co ....... (–) .., 3 <br /> OwnerlAutho ed A nt Signature Bate (Re.vised Wala20.143,1 <br />