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Feb 24 2017 01,44PM Washington Water Heaters 8663757454 page 3 <br /> PERMIT APPLICATION <br /> BUILDING I MECHANICAL 1 PLUMBING I SIGN 1 SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERM JT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 96201 <br /> (P)425-257-8810 1 FAX 425-257-8857 i(E)everetteps@everettwa.gov I www.everettwa.govipermits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 131q ��lV D PROPERTY TAX#:6 0 13 t' o 0106 <br /> LEGAL for new construction, ShortPlatlsubd vision _ Lot No (attach copy of long legal description) <br /> � <br /> `'� CONTACT INFORMATION <br /> OWNER NAME: r,t,r (,� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET f 1170 Ra <br /> CITY USW STATE OWlg� ZIP <br /> OWNER PHONE; G OWNER EMAIL: <br /> CONTRACTOR NAME: l�(J�St�t NG►TGt� ��� f T6-�u <br /> CONTRACTOR ADDRESS: sraEeT I�T15Z `� V <br /> CIN L LV v7 l STATE /7 DP <br /> CONTRACTOR PHONE: 4Z6493— ! CONTRACTOR E�MAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): W,,4 -)t ffj CIYEF2ETT BUSINESS LICENSE#(REQUIREQ): <br /> PRIMARY CONTACT; ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONAC{T�NAME CONTACT PHONE: ,2J� 3_[/g 7 <br /> �Jh ����� CONTACT EMAIL; fjL�jJ L <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ V Q <br /> Proposed Use of Building: Heat Source: kQQ ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached -Attacned ❑Duplex ❑Multi-Family-#of Units: ❑Commercial 01 ustrial <br /> Type of Project ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sin ❑S rinkler ❑Demolition ❑Change of e <br /> DESCRIPTION OF WORK: <br /> ASSOCIATED 13UILDING PERMIT#(if ap licable): <br /> MECHANICAL PERMIT PLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn ration _iZepair Type of Project: New Addn `Alteration Repair <br /> #of #of #of <br /> Fixtures List of Fixtures List of Fixtures #of List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures <br /> AIC—Air Handling Units Heat Pump Toilet Backflow ter <br /> (inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Jana <br /> Gas Pipin Bolter Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refri oration Shower FlocrDrain <br /> Gas Fireplace Wood Stove Kitchen Sink&Dis osai Grease Trap <br /> Gas Range Ducting 1)ishwasher Roof Drains <br /> Clothes Dryer Hookups Other: lClothes Washer Medical Gas <br /> Range Hood Water Heater <br /> Other; <br /> Exhaust Fan Sink(SerViceiBarlMo ietc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKA(0 W EOGEMENT/have reviewed this application and con/rmn the irrcrmarfon contained l:e ein is true and correct.Work done pursuant to this permit must comply with <br /> current federa., state,and local law.The granting or a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in venting from the <br /> Building Ofriciel betbre being authorized under any circumstance.i am the owner,or I am authorized by the owner of this property to perform the work for which 3ppr1cation is made, <br /> and i comply with the State Contractors Law ia. Wand 296.200A WAC. <br /> City of Everett Official use Only <br /> PER — <br /> erAuthorized Agent Signature Date (Revised 5120/2016) <br />