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Feb 24 2017 01:47PM Washington Water Heaters 8663757454 page 7 <br /> PERMIT APPLICATION <br /> BUILDING I MECHANICAL J P,�UMBING I SIGN <br /> IG ctSPRINKLER 1 DEMOLITION <br /> CITY OF- <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 i(E)everetteps@everettwa.gov l wvrw.everettwa.govtperrnits <br /> (Blue or Black Ink Only Please) PRO.IECT SITE INFORMATION <br /> I dingy PROPERTY TAX#: G CJSI �G <br /> PROJECT SITE ADDRESS: �b l +-iof tong legal description) <br /> LEGAL for new construction: Short PlaUsuboivision <br /> Lot No tattacti copy <br /> CONTACT INFORMATION <br /> TENANT NAME(If Commercial): -- <br /> OWNER NAME: nA <br /> OWNER MAILING ADDRESS: STREST <br /> (p rP STATE W z1 P <br /> CITY Imo' `- <br /> OWNER EMAIL: <br /> OWNER PHONE: p��/ / _s <br /> CONTRACTOR NAME: V J4501 Al G1TGN <br /> ox yup <br /> CONTRACTOR ADDRESS: STREET I-71-5-z— <br /> STATE bi zip <br /> ,/ / c(rv�� J CONTRACTOR EMAIL: V 6ILz <br /> CONTRACTOR PHO NE: 72J"-b 3— p`�p <br /> CONTRACTOR LICENSE#(RE4UIRED): i�i# qOfl(X CITY OF EVERE7T BUSINESS LICENSE#(REQUIRED): ��T <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NpeME• <br /> CONTACT PHONE: �L J �� <br /> Ir I � �� CONTACT EMAIL: (A!{}-�rtll�}f�./f[ <br /> V r,`�-/ BUI DING PERMIT APPLICATION <br /> Exist ng Use of Building Contract ince .3 <br /> Heat Source: fectric 00th <br /> Proposed Use of Building: <br /> BuildingType: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famil -#o nits: <br /> ❑Commercial ❑lndustri <br /> Type cfProject: ❑New ❑Addition El Remodel ❑Repair ❑T.I. []Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> /j� 6 <br /> DESCRIPTION OF WORK: / 1 A(/"`^" <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn ____Alteration ,Repair Type of Project: New �Addf I ration Repair <br /> #of #of #ur List of Fixtures <br /> --f— <br /> #of List of Fixtures Fixtures <br /> List of Fixtures Fixtures List of Fixtures Fixtures <br /> Fixtures Backflow Preventer(inside Bldg) <br /> A/C-Air Handling Units Heat Pu -rmp oilet <br /> Unit Heater Bathtub Urinal <br /> Forced Air Systems Drinking Fountain <br /> Lavato <br /> Boiler (Wash Basin <br /> Gas Piping Shower Floor Drain <br /> Water Heater Refrigeration <br /> Gas Fireplace Wood StaveMsher <br /> Sink&Dispo21 — Grease Trap <br /> Ducting Rocf Drains <br /> Gas Range Medical Gas <br /> C othes Dryer Hookups Other: s Washer <br /> Ran a Hood <br /> Heater OtherExhaustFan ervicali3ar)MOther: <br /> SPRINKLER i SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNO WLEDGEMEnrT•1 have reviewed this application and confirm the information contained herein fs true end correct.Work done pursuant to this Perm?(must compry with <br /> autnanzes approved work and no deviations therefrom.Deviations must first he authorized in writingfrom <br /> the <br /> current federal,state,and focal taw.The granting of a Permit only made, <br /> Building Cfrciet before being authorized under any Circumstance,f an, the owner,or!am authorized by the owner of this property to perform the work for titch app <br /> cornpfy with the Stet--Contractors Law 19.27 RCW and 296.200A WAC City of Everett Orriiciat Use Onfy <br /> PERMIT# oO� <br /> 1 wnorJAuthorized Agent Signature Date <br /> (Revised 5x20/2016) <br />