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PERMIT APPLICATII e
<br /> BUILDING/MECHANICAL/PLUMBING /SIGN/SPRINKLER I DEMOLITION
<br /> EVERETTCITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT.WA 9$201
<br /> wasitI>eerow (P)425-257-5810 1 FAX 425-2,57.8957 1(E)everetteps@everettwa.gov I www,everettwe.gov/permits
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<br /> PROJECT SITE ADDRESS: 612 34th Street PROPERTY TAX#: 00561900203401
<br /> LEGAL for new construotion: Snort Plat/subdivision Lot No. (attach copy of long legal description)
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<br /> OWNER NAME: Bruce Cooper TENANT BUSINESS NAME(Commercial):
<br /> OWNER MAILING ADDRESS: STREET 612 34th Street
<br /> ory Everett STATE WA ZIP 98201
<br /> OWNER PHONE: 425-210-6616 OWNER EMAIL: b.cooper25@comcast.net
<br /> CONTRACTOR NAME: Washington Water Heaters
<br /> CONTRACTOR ADDRESS: STREET 17152 116th Ave SE• •
<br /> GIT. Renton STATE WA ZiP 98088
<br /> CONTRACTOR PHONE: 425-883-4871 CONTRACTOR EMAIL: wawahvac@gmail.com
<br /> CONTRACTOR LICENSE#(REQUIRED):WASHI I'"98OQP CITY OF EVERETT BUSINESS LICENSE#(12SQUIRED): 05344Q
<br /> PRIMARY CONTACT: ❑OWNER l:I CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME; CONTACT PHONE; 425-883-4871
<br /> JACCI DANIELS • CONTACT EMAIL:wawahvac@gmaii.com
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<br /> Existing Use of Building: residentail Contract Price of Work: $1660 ••
<br /> Proposed Use of Building: Heat Source:___E_ Cas ❑Electric ❑Other
<br /> BUILDING USE: ul;FR Townhouse ❑Du•lex ❑ADU ❑Multi-Family-#Units; ['Commercial ❑Access° Stru - _
<br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair UT.1. Dsign DSprinkler ❑Demolition ❑Change of Use 417,6 f
<br /> DESCRIPTION OF WORK; remove&replace 1 gas water heater in utility room '
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
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<br /> Fixture Fixture Fixture Fixture
<br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures
<br /> AIC—Air Handling Units Gas Piping • Backflow Preventer(Inside Bldg) Shower,Tub,or Combo
<br /> Boiler Gas Ran-e Clothes Washer 111=1 Sink-`•mmeroial 3-corn.,.re.,floor
<br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar)
<br /> Duct System(Remodel) -Refrigeration Drinkin•Fountain Sink-Utility,laundry,mop
<br /> 1111.11111=13103.- •en tai Commercial Ventilatio Floor Drain Toilet
<br /> IIIIExhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal
<br /> Exhaust Hood(Type II) 1 Water Heater Interceptor-Grease Wastewater Pipin�Repair
<br /> Exhaust Hood(Residential) Wood Stove Interceptor 5sntllOil • Water Service(behind meter)
<br /> Forced Air Systems Other, Medical Gas Water Valves or Fixtures
<br /> Gas Fireplace/Insert/Log Roof Drains Water Heater
<br /> •;:r;:!:r:!;,;,$A.00.1 ,1 IF 001 f : 00#0I **0110lil';;n3` ..1 Sewage Ejector or Sump Pump Other
<br /> Water Suppression System' No.of Heads
<br /> Chemical Suppression System I No.of Heads
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<br /> ACKNOWLEDGEMENT:I 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 approved work and no deviations therefrom.Deviations must first be authorized in writing from the
<br /> Building Official before being authorized under any ci msterlCe.tam the owner,or lam authorized by the owner of this property to perform the work for which application is made
<br /> end I comply with the State Contractors Lew 1$.27 and 286.200A WAC.
<br /> City of Everett Official Use Only
<br /> 4 iria 4. ' I/ • [ PERMIT#ivt
<br /> 12/27/19
<br /> O 'er/Authorized Agent Signature Date (Revised 10/10/2018) -
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