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<br /> PERMIT APPLICATION
<br /> BUILDING I MECHANICAL 1 PLUMBING I SIGN I SPRINKLER 1 DEMOLITION
<br /> E VERETT CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> WAShrrieT.ON (P)425-257-8810 I FAX 42 -257-8$57 i(E)everetteps©evereitwa.gov I www,everettwa.govlpermits
<br /> .0. ,0450 0410ifl y,*0I :0044 1E+„„ „ IR ,0 i$St#0 ; ., ; +' ; ,
<br /> PROJECT SITE ADDRESS:1105 HOYT AVE PROPERTY TAX#:00468622101300
<br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)
<br /> OWNER NAME: TEN
<br /> .:.,,`.•`. ' . � N ',,+ ��0SINESS NAME Col' c.,,, .. ;,� � r :
<br /> PAUL SHOTWELL (Commercial):
<br /> OWNER MAILING ADDRESS: STREET 1105 HOYT AVE
<br /> cm! EVERETT STATE WA zip 96201
<br /> OWNER PHONE: 425-903-0264 OWNER EMAIL:NIA
<br /> CONTRACTOR NAME:WASHINGTON WATER HEATERS
<br /> •
<br /> CONTRACTOR ADDRESS: STRMY 17152 116TH AVE SE
<br /> cny RENTON STATE WA ZIP 98058
<br /> CONTRACTOR PHONE;425-883-4871 CONTRACTOR EMAIL;WAWAHVAC ra GMAIL.COM
<br /> CONTRACTOR LICENSE#(REQUIRED):WASHII*9800P CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)): 053449
<br /> PRIMARY CONTACT: M OWNER 0 CONTRACTOR I]OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:425-883-4871
<br /> JACCI DANIELS CONTACT EMAIL:WAWAHVAC@GMAIL_COM —u
<br /> : 3,aj1 ! I t{ '� ..i. ;c 'rms,'HPvb11 y� : j'� I1100 4C, F . f,::' 1,1 1 :', < rev;e'..I • .•.k, 1
<br /> Y �i1.M�.-�T'��f....:3',k 1 °i l:l /t{ OJ � OR 1 �
<br /> Existing Use of Building:RESIDENTAIL Contract Price of Work:$1450
<br /> Proposed Use of Building: Heat Source: OGas DElectric DOther
<br /> BUILDING USE: I]SFR ETownhouse ❑Duplex ❑ADU ❑Multi•Family-#Units: ❑Commercial ❑Accessory Ct ��`,��`
<br /> Type of Project New ❑Addition ERemodel ❑Repair T.I.❑ ❑Sign ❑Sprinkler ❑Demolition ❑Change of se' �
<br /> DESCRIPTION OF WORK: REMOVE&REPLACE 1 GAS WATER HEATER • c:___ `
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> r
<br /> a+Il; l :00#0I0.. Ik PEti( Ir 0 X01. y�syk<<t¢gat� l025 �� PLt M fN,4# ail "�' 1�i 00.0 g , ji;r`r�' + fi%
<br /> ., ... .. '.1,., �, 1�, � � �. .,,.x c;. .....,_r f ..r�-1":�i3�-�q ,........ ,� .. �....�L 1)7r'�T J9",x.,� '�'�'_..Rl �I... Ilr�
<br /> RA-Wm List of Fixtures F&iure Fixture Fixture
<br /> Count count list of Fixtures Count List of Fixtures Count List of Fixtures
<br /> NC-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo
<br /> Boiler Gas Range Clothes Washer _Sink-Commercial(3-comp,prep,floor)
<br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar)
<br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink•Utility,laundry,mop
<br /> Exhaust Fens(Residential) Commercial VentilatorT Floor Drain Toilet
<br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb _ Urinal
<br /> Exhaust Hood(Type II) 1 Water Heater Interceptor-Grease Waste/Water Piping Repair
<br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter)
<br /> Forced Air Systems Other. Medical Gas Water Valves or Fixtures
<br /> Gas Flreplacellnsert/Log Roof Drains Water Hpter
<br /> "`r', SP••'INKLE 1 UP0 E :*). �/ . .,
<br /> � ,u. „-..,.,'?x„ ,, ,. 1`.,. .,.,, ..�� .�� ..+,,.�:k�� �! l��:N� Sewage Ejector or Sump Pump Other: -
<br /> N'a ersuppresslon Syseem No.of Heads
<br /> Chemical Suppression System 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 Idea/law. The granting o a permit ontyauthorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the
<br /> Building Official before being authorized under any raumstance.1 am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made,
<br /> comply with the State Contractors Law 18.27 CW and 296.200A WAC.
<br /> City of Everett Official Use Only
<br /> _ _ '('�;/� ti' — /9 PEA,MT ill I 1 Ceq)
<br /> wnerlAu orized Agent Signature Date (Revised 10/1012018)
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