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Feb 24 2017 01;46PM Washington Water Heaters 8663757454 page 6 <br /> PERhAIT APPLlCATiON <br /> BUILDlNG 1 MECHANICAL/PLl1M6lNG /SIGN 1 5PRlNKLER! DEMOLITION <br /> CITY OF EVcRETT PEftMIT SERViGES <br /> 3200 CEDAR S7REET, EVERETT,'J4'A 88201 <br /> ip�42G-257-8810 � FAX 425-257-8857 �(E)everetteps@evere3twa.gov J w►vw.evereitwa.gov/permits <br /> (Blue or Biack lnk Only PI ase) PROJECT SITE II�l�ORMATION <br /> PROJEC7 Si7E ACIpRESS: � � � PROPERTY T,4x#:(�U�� ��}����tJ� <br /> LEGAL for new�anstructio�: Short PIaYlsubdiv'sfon Lot No.� (aEtach caRY of long fegal description) <br /> CONTAGT fIVFORMA710N <br /> OWNER NAME: ` 7ENANT NAME(If Commercial): <br /> OWhlER MAILlNG ADDRESS: SrREE- r �J�p f3""�j'V� (/}e �, <br /> cirr `Cj/^�,'i�' srr.re W� zh, �3 <br /> OWNER PNONE: j � OWNER EMAIL: <br /> CONTRACTOR NAME �/�'SJ-f�l�/G7 T-�N �}-'�f� ��7�,-�� <br /> COAI7RACTDR ADDRESS; srrteer J�(5 Z �r� � �-�� � — G D�C �� <br /> crrr -�Y1;�1{� sr�re {�� zia <br /> CONTRACTOR PHONE: �Z J'��-� CON7f2ACTOR EMAIL: {l � /h/�}((,,,� C�YY <br /> CONTRACTOf2 LICENSE#(REQL'IRED): �i(J��� g��p CITY OF EVERETT�(JSItVES5 LICENSE#{REQUIREp): � ,� � <br /> PRIMARY C4N7ACT: ❑ p1NNER CONTRACTOR ❑OTHER(Pieasa Specify) <br /> CON ACT N4M • CONTACT AHONE: '�C� 3_��'�, <br /> ��r ��«��� CONTACT EMAIL: (��J�hf� �Y l� <br /> r}��[�+ 1r�L C UY ! <br /> BUILDING PERMiT APPLICATION <br /> Existing Use of 8uildin : Contracf Price of Work:$ <br /> Proposed Use af Building: Heat 5ource: C7Gas tric OQttter <br /> Building Type: �SFR-De;ached R-Attached ❑Du lex �Multf-�amily-#of Units� OCommerciai Dlndustrial �\ <br /> Type af Projecr ❑New ❑Addition ❑Remodei ❑Repair ❑T.L ❑Sign ❑S rir�kler ❑Demol'Ition �Change of Use <br /> DESCRIPTIQN OF WOl�K: <br /> ��� �P�e-Q L �e c�-�,c_. wc�-�c-v� �c�,�e,� <br /> ASSOCIATED BUILDING PERMIT t�(ff applicableJ: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMI'T APPLICAI"ION <br /> Type of Project: ,^,New_ Addn �Alteration _Repair 7ype of Project: IVew Addn Alieration _Repair <br /> #of #of � — <br /> Fixtures ��st ol�xtu�es List af Fixfures #°f Lisf of Frxiures 1�of <br /> Fixtures Fixtures Fixtures <<St of Fixtures <br /> .S/C-Air Handling Units Naat Pump Toilet Backflow Preventer{Inside 81dgJ <br /> Forced Air S siem� UniY Heater Bethtub Urinal <br /> Gas Piping Boiler Lavato Wash Basin - <br /> VJaier Heater �� ry� ) Drinking Fountain <br /> Refr era�ion 5hower Floor Drain <br /> G�s Firepface Wood Stove Krtchen Sink&Disposal Grease i"ra <br /> Gas Ran e p <br /> 9 Ducting Dish��rasher Roaf prains <br /> Cfothes Dryer Nooku s Other. Clothes Washer Medical Gas <br /> Range Hood Water Heaier Other: ' <br /> ExhaustFan S nk(ServicelBar/Mop/etc. Other� <br /> S�RfNKi.ER!SUPPRESSION SYSTEM i <br /> Number of Heads <br /> ACKNOWLEDGEN,E�'V7:1 have reviewed thr's applicaNen and confirm fhe inlorr,�a/ion confainedlrerern rs true and correc,_ Work tlone purswant to this permu must comply K�th <br /> current ledera/sta[e,ei,d Jxa!law. The grantrng o!a oermit only autha'izes appro�ed work and no devrations the�efrom.Deviations mus!9r,t be authorized�n vmting from lhe <br /> 8ui/dinq O/frcia7 before being autho�ized under any circumstance.!em the ow,ier, or/am au7ho.dzed by the owner of!his property to peAorm the work!or which appJication is made, <br /> an co plywi(h the State Cont•actors f.aw 18.27 RCW an 96.200A WAC, <br /> /J � , City of Evasetf Ofiicial Use On/y <br /> LX�[// l^ ��jr` � PER T <br /> L � � ��a 0 Z <br /> 0 rlAutharlxed A[�ent Signafure Date !Revised 5/20/2p16) <br />