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MN <br /> PERMIT APPLICATION <br /> LIN <br /> BUILDING /MECHANICAL/ PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> EVERETTCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 i(E)everetteps@everettwagov I www everettwa.gov/permits <br /> Igloo or Black Ink On Please PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3424 SHORE AVE PROPERTY TAX#:00571700701100 <br /> LEGAL for new construction, Short Platisubcfmsfon Lot No, (attach copy of bng=egal descnotion) <br /> CONTACT INFORMATION <br /> OWNER NAME: G1LLOW, ea84A4 B fz..1 fiN TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sr-au:73424 SHORE AVE <br /> crry EVERE I I STA rE WA zip 98203 <br /> OWNER PHONE: 425-754-4743 OWNER EMAIL: <br /> CONTRACTOR NAME:WASHINGTON WATER HEATERS <br /> CONTRACTOR ADDRESS: STREET 17152 116TH AVE SE DO BOX 59208 <br /> cry RENTON m WA -zp 98058 <br /> CONTRACTOR PHONE:425-883-4871 CONTRACTOR EMAIL:WAWAHVAC@GMAILCOM <br /> CONTRACTOR LICENSE#(REGUIRED):WASH11*9800P CITY OF EVERETT BUSINESS LICENSE e(REQUIRED). 053449 <br /> . , <br /> PRIMARY CONTACT: 0 OWNER 123 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-883-4871 <br /> DANIELS, JACCI CONTACT EMAIL:WAWAHVAC@GMAIL.COM <br /> BUILDING INFORMATION <br /> - <br /> Existing Use of Budding.RESIDENTIAL Contract Price of Work:$1200 <br /> _. ....._,_ <br /> Proposed Use of Building: Heat Source. OGas OElectric DOther <br /> --row---- , <br /> BUILDING USE 08FR EiTowntiouse ODuplex EADU liftaluiti-Famtiy-#units: EComrnercial rjAccessory Structure \ <br /> . <br /> Type of Project: ONew OAddition ElRernociel ERepair LIT.I. 1.:3Sign EjSprinklef EDemolition Eithenge Of Use - . . .• .f. <br /> DESCRIPTION OF WORK: REMOVE&REPLACE 1 ELECTRIC WATER HEATER <br /> AM2baua3a.izijpjmFmpjnpsliEaIL _ __ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> FiXtUreFixture Future <br /> List of Fixtures Ilwe List of Fir-tures List of Fixtures List of Fixtures <br /> Count 'aunt Cotint Count <br /> 11111111.111 NC-Air Handling Units 1111111111 Gas Pl.in 1 Backf ow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> IIIIIIIII Boiler 11111111111 Gas Ran.e Ciothes Washer Sink-Commercia(3-com. .rep,f1oor) <br /> MI=Clothes Dryer Mil Heat Purnp&Ductless Dshwasher Sink-Residential(kitcheo,bath,bar) <br /> Duct System(Remodel) MI Refngeratior Drinking Fountain Sink-Uttay,laundry,mop <br /> Exhaust Fans(Residential) al Commerciai veritiat.il ,;'ioor Drain Tote: <br /> Exhaust Hood(Type I) (Not Heat/AC system) IMO Hose Bibb <br /> Urinal <br /> ME Exhaust Hood(Type II) Water Heater . Interceptor-Grease WasteNVater Piping Repair <br /> Exhaust Hood(Residential)MI Wood Stove Interceptor-Sand/011 Water Service(behind meter <br /> Forced Air Systems Mil Other Medical Gas Water Waves or Fixtures <br /> MN Gas Fireplace/Insert/Log IIIIIIIIII Roof Drains , Water Heater <br /> . . <br /> SPRINKLER/SUPPRESSION SYSTEMSewage Eiector of Sump Pump <br /> MINIOther, <br /> Water Suppression-ystem MIN No o Heads <br /> Chemical Suppression System No,of Heaos r <br /> 4._ <br /> ACANCWLEDGEMENTI 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 a permit only authorizes aiproved wmit and no deviations therefrom Deviations must`irs.t be authorized in writing from the <br /> Building Official before being authenzed under any circumstance I aM)the owner,or!am authonzed by the owner of this property to perform the work for which application is made, <br /> encl./ceinibity.with the State Contractors Law 18.27 RCW and 296.204A WAC <br /> City of Everett Official Use--.Orly <br /> . l' .—.....,.......a..i.i.—....... <br /> i , <br /> v t D . <br /> •_ • . ,,,, ,, , - Ei7/19 <br /> OwneriAtnhorited Agent Signature Date (Revised 10/-l012C,18) <br />