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03/24/2016 THU 10: 53 FAX 4252521666 Cm Heating 0002/003
<br /> 48-17 PERMIT APPLICATIO.1
<br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION
<br /> CiTY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 96201
<br /> (P)426-267-8810 I FAX 425-257-8857 1 (E)everelleps©everettwa,gov I www,evereitwa.gov/permits
<br /> ' ;;ip;?r;".;,! ``''?4•;:: : . sPROJECT SITE INFORMATION • . •
<br /> PROJECT SITE ADDRESS! 307 }1, C` --` PROPERTY TAX#:
<br /> LEGAL for new construction: Short Plat/subdivisiofn'_`�I Lot No, (attach copy of long legal description)
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<br /> ;;r):,,t aM,'; lg , :..,vlr,{i ,l' :,:!r, '; ,I.,.s..,7 '.:',...•,.., CONTACT INFORMATION
<br /> OWNER NAME: J 5-t')� Jo fr �x'i TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: `J STREET S 02 -t-i s'i �/({
<br /> CITY STATE A7.IP 920(J
<br /> OWNER PHONE: +J (7 -2962q OWNER EMAIL:
<br /> CONTRACTOR NAME: }� , min ]1 i N
<br /> CONTRACTOR ADDRESS: STREET t 1') 0gU "pvvA
<br /> '2- CVL Pe STATE V`Jl 2IP CI Ll:
<br /> CONTRACTOR PHONE: —j .2- 0j ESQ CONTRACTOR EMAIL; iy-p , d 0i c y-tv c go1
<br /> CONTRACTOR LICENSE#(REQUIRED): rr 'Lai 111d/\ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): , lili;n ill
<br /> PRIMARY CONTACT: ❑OWNER N CONTRACTOR Li OTHER(Please Specify)
<br /> CO,J TACT AME; CONTACT PHONE: H S �Q 5-Q {�
<br /> an heck+�� �'Y1P2Car t
<br /> ( _ CONTACT EMAIL; !" .ecr I Aq corn
<br /> tt t l,;,,, ,`.-'',!,?;, 5pAii 1'f;i,,,?: ',• ,'o7r.c.7:i BUILDING PERMIT.APPLICATION• :t;.i:r,:'' ,. .
<br /> Existing Use of Building: Contract Price of Work: $ 11 d 0
<br /> Proposed Use of Building: Heat Source: *as DElectrlc ❑Other
<br /> Building Type: ❑SFR-Detached *FR-Attached ❑Duplex ❑Multi-Family-1#of Units: ❑Commercial ❑Industrial
<br /> Type of Project: ew kddition ❑Remodol ❑Repair DTI ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use
<br /> DESCRIPTION F WORK:
<br /> insfut d,L4C+LeacV p-wiLp
<br /> ASSOCIATED BUILDING PERMIT# (If applicable):
<br /> Y`f ttfi1nl'r `;�' 00,06,IT!A 13.LI'CATION�.'_ PLUMBING,PERMiT APPLICATION .
<br /> Type of Project: New Addn _Alteration _Repair Type of Project: New _Addn _Alteration Repair
<br /> #of List of Flxturos #of
<br /> Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures
<br /> A/C —Air Handling Units I Heal Pump Toilet Backflow Preventer (inside Bldg)
<br /> Forced Alr Systom9 Unit Heater Bathtub Urinal
<br /> Gas PlEing Boiler Lavatory(Wash Basin) Drinking Fountain
<br /> Water Heater Refrigeration Shower Floor Drain
<br /> Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap _
<br /> Gas Range Ductlnq Dishwasher Roof Drains
<br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas
<br /> Range Hood Water Heater Other:
<br /> ,�1__�_,�_ Exh'yya�ustii��Fan
<br /> ��II 5 nk_Servlce/Bar/Mop/etc.) Other:
<br /> +ins y�i,il'sL$0 i$.00;11%MiPPRES5 ONi*' 8TEM ' .
<br /> Number of Heads
<br /> ACKNOWLEDGEMENT.'I hada reviewed this application and confirm the information contained herein is true end correct. Work done pursuant to this permit must comply with
<br /> current federal,state,and local law. The granting of e 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 eirvumstance,i em the owner,or I am authorized by the owner of this property to perform the work for which application Is mads,
<br /> end!comply with the State Contractors Law 18,27 RCW and 290.200A WAC.
<br /> j / City of Everett Official Use Only
<br /> r /,,/ �, / QUI l PERMIT#
<br /> Owner/Authorized Agent.ignetu , - Date (Revised 10/1y2015)
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