Laserfiche WebLink
04/25/2017 TUE 10: 32 FAX Fabt water Heater U002/008 <br /> I � I� <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL,I PLUMBING /SIGN I SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT 6ERVICF_S <br /> 3200 CEDAR STR'E'E=T,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257,8857 1(E)avaraltapsoavereuwa.gov I www.everettwa.gov/parm[ta <br /> Blue or Black Ink Only Please) PROJECT WTO INFORMATION <br /> PROJECT SITE ADDI P-5S: PROPERTY TAX#: LOWIM06 <br /> LEGAL.for now construotion: Short Plat/subdlvlslon Lo(No. (attach copy of long legal descriplion) <br /> CONTACT INIFORMATION <br /> OWNER NAME: KLbFL&H, O TENANT NAME if Commerclal): <br /> OWNER MAILING ADDRESS: srncar -Y.-a <br /> cnr srATa 21P <br /> OWNER PHONE; OWNER EMAIL: <br /> CONTRACTOR NAME; S� T <br /> CONTRACTOR ADDRESS: STREET {{��� <br /> crrr t/ BUIE PIP <br /> CONTRACTOR PHONE: pL S CONTRACTOR EMAIL: em vT S <br /> CONTRACTOR LICENSE#(REQUIRED): S Nq Li SCI CITY OF EVERETT BUBINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR 13 OTHER(Please Speolty) <br /> CONTACT NAME: CONTACT PHONE: <br /> Krl 1 l� CONTACT EMAIL: A'J-�S <br /> BUILDING PERMIT APPLICATION <br /> Exletlng Use of Sulldln : Contract Price of Work:$ <br /> Proposed Use of Buildi Heat Souree: ❑Gas leclrle ❑Other <br /> 41— <br /> Building e: FR-Detached EISFR•v0.ttached ❑Du lex 1=1Multl-Famll -#of Units' ❑Commarclal ©Industrial <br /> e of Pro ect: CINew []Addition EIRemodel ZRepair OT.I. ❑SI n LIS rinkIar ElDemolltion ❑Chan a of Use <br /> 13"CRIPTION OF WORK: <br /> f-e,m 00 ( � �e���c Alec )'C LAJ <br /> ASSOCIATED BUILDING PERMIT# If applicable): <br /> MECHANICAL PIwRMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> "type of Prole _ _ Addn ,_Alteration pair 'type of Project: _New _1Addn _Alteration _Repair <br /> #of Llst of Ffxt #of at of Fixtures vat of Flxturaa ✓i of L/st of Flxturee <br /> FWur Fbitures Flxfuraa Pktures <br /> jr A1C—Air Handling Heat Pump Toilet Backflow Preventer Inside Bldg) <br /> Forced Air Sys tarris Unit Healer Bathtub Urinal i <br /> Cas Piping Boller Lavatory Wash Basin Drinking Fountain <br /> Water Heater Refrl eratlon Showor Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Rancie DuctIng Dishwasher Roof Drains <br /> Clothes 05ydr Hookups Qthar., Clothes Waaher Medical Gas <br /> an ood Water Heater Other: <br /> Exhaust Fen Sink (Service/Bar/mop/etc. Other: <br /> SPRIN �SS10 1fS'f� <br /> emlcal or -O,of Heads <br /> ACKNOWLEDGEMENT-I have reviewed thla appl/callon and confirm the lnfonnallon c°nlelned heroln Is true and correct.Work done pursuant 10 this parmlt mull Comply with <br /> current federal,data,and local law, rhe grendho of a permit only authorizes approved walk and no davlallons Morefrom.DevWlons must llrst be outharizad In Wnling from the <br /> gullding Off/clal before bo/ng aulhork®d under any olreumslance,l em the owner,ori am aulhodzed by the owner of this preperly to perform the work forwhlch appllcallon N maria, <br /> olid/comply with the Efate C:onlraclors Law 18,27 RCW and 29&200A WAC. <br /> City of Everolt Official Use Only <br /> �J,N L�Ub �� 1q— 1PERMITfFil�n <br /> Own uthof za Ay Signature Date (Revised B/23/20i <br />