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NM , • PERMIT APPLICAT.
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<br /> BUILDING/ MECHANICAL I PLUMBING I SIGN /SPRINKLER/DEMOLITION
<br /> EVERETT CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> VYASHINO TON (P)425-257-8810 I FAX 426-257.8857 I(E)OverettepeCaverattwa.gov I www.everettweLgov/permits
<br /> ($h#44iSiclo' IitiOnoilisiWfoii'.0101.4001t*Iirrifirlf***100;r::"';:':''':: . ''''': ' '':7,,:i, '''' : ',' '' ''' '.f.' •,.
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<br /> PROJECT SITE ADDRESS: 11325 19TH AVE SE, UNIT 208C PROPERTY TAX#;00826200320800
<br /> LEGAL for new construction. Short Psubdlvo joI No, (attach copy of long legal diescrip/lon)
<br /> .., . .., ; . . : ',:' . , ', .,, ,,! ,' - ", ' , • CONTACT INFORMATION •.' • — : • .:' ! , :.:. ,; H.. -, :::: . :':
<br /> OWNER NAME: JANIS MARGIN TENANT BUSINESS NAME(Commercial):
<br /> OWNER MAILING AODRE$8; m1411=11325 19TH AVE SE, UNIT 208C
<br /> — -,*414110AWN.
<br /> CM, EVERETT VATS WA ZIP 88208
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<br /> OWNER PHONE:425-337-1936 • OWNER EMAIL:FLASHY8914@AOL.COM
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<br /> CONTRACTOR NAME:WASHINGTON WATER HEATERS
<br /> _____,.........
<br /> CONTRACTOR ADDRESS: raeey17152 116TH AVE SE
<br /> crry RENTON
<br /> STATE WA np 98058
<br /> CONTRACTOR PHONE:425-883-4871 CONTRACTOR EmAILWAWAHVAC@GMAILCOM
<br /> CONTRACTOR LICENSE ftREQUIRED);WASHII*9800P CITY OF EVERETT BUSINESS LICENSE*WU:WIRED); 05344
<br /> PRIMARY CONTACT: DOWNER In CONTRACTOR 0 OTHER(Please Specify) , ,.......
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<br /> CONTACT NAME CONTACT PHONE:425-883-4871
<br /> JACCI DANIELS CONTACT EMAIL;WAWAHVACQGMAIL.COM
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<br /> Existin USG Of Buildin i RESIDENTIAL ' Contract Price of Work:$1300
<br /> Proposed Use of Building Heat Source: EJGas Electric Dottier
<br /> BUILDING USE: IJSFR OTownIlouse ODuplex OADU EDMulti-Family-it LInits: t OCorprnercial EAcoessory Strut r:-
<br /> ViPlifff Type of Project: :New pAcklition ORemodal DRepair DTI. OSIQn OSprinkier EDemolition °Change of use '
<br /> DESCRIPTION -..„..--
<br /> OF WORK; REMOVE&REPLACE 1 ELECTRIC WATER HEATER
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<br /> ASSOCIATED BUILDING PERMIT#(if applinable -
<br /> ; . s
<br /> 777j ECSAfr,,..„.2. 144:041W000:00lit 01440,irffi4011001**OE') 104 I1At0004110,4:;jiiiPanZI
<br /> Fixture Fixtura Fixture
<br /> iFixture
<br /> Litt of Fixtures List of Fixtures List of Fixtures Litt of Fixtures
<br /> Count Coma Count COUnt
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<br /> A/C-Air I fond (I ling NN Gas FionL Beddow Preventer(Inside 8Id9) Shower,Tub,or Combo
<br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comP,prep,floorj
<br /> Clothes Dryer II 1 Heat Pump&Ductiess Dishwasher Sink-Residential(kitehen,beth,bar)
<br /> (Remodel)Duct SystemRefrigeration Drinking Fountain Sink-Utility,laundry,mop
<br /> Exhaust Fans(Resicientiali commeroiel Ventileitlor Floor Drain Toilet
<br /> Exhaust Hood...crypts i) (Not Heet/AC system)
<br /> Rosa Dial
<br /> Urinal
<br /> Exhaust Hood(Type II) waterkeater Interceptor-Grease Waste/Water Piping Repair
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<br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sandl011 Water Service(behind meter)
<br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures
<br /> 4
<br /> Gas FirepiacerinseitiLo9 Roof Drains 1 Water Hester .
<br /> --rrHits. s, - • , ••i • " .-, 7 OA* ''':tni,
<br /> ;:'100.04(0,1040041111000 ON '• ' OV';!Vir, Sewage Ejector or Sump Pump Other/
<br /> ti.1.11•11111MW
<br /> water*duppression System --4o.ot4eas
<br /> Chemical Suppression System No.of Heads
<br /> ACKNOWLEDGEMENT:I hews reviewed this application end confirm the Infoinstion conttrieed herein is true end odmeor• Work done pursuant to this permit must comply With
<br /> Ctiff"16k**state,and*al law,The tilralaihO of$What only author/1*s approved work and no deviations tnher. m peurewe mu*(set tie 400106nd in wrong from the
<br /> Buridirvi Official before being authrxized under any ci urestence.I am the owner,or/am authorized by the owner of this property to perform the wort(for 1010 application is mach
<br /> and 1 comnty with the State Contract° taw 18.27 CW and 2913.200A WAG.
<br /> C City of Everett Official Use Only
<br /> Lilt(I 1 PERMI # .
<br /> 10/19/19 \0 1 D- Ul
<br /> *1.11•M...1101P
<br /> 0 rfAuthorixed Agent Signature Data **(Revised 10/10/2018) '
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