Laserfiche WebLink
08/23/2017 WED 14: 39 FAX Fast water Heater002/008 <br /> PERMIT APPLICATION <br /> BUILDING I MECHANICAL I PLUMBING / SIGN/SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98209 <br /> (P)425-257-x890 I FAX425-257-68b7I(E)everetteps®avereltwa.gov I wwweverettwa.gov/perm[(, <br /> Blue np Elack Ink Only Please //�� PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: P�JP� W AL PROPERTY TAX#: D OV Y <br /> LEGAL For now wn6tructivn: Short PlaV,ubdlviston Lot No. (attach copy of long legal deacrlpllon) <br /> CONTACT INFORMATION <br /> OWNER NAME 1 TENANT NAME IF Commerclal): <br /> OWNER MAILING ADDRESS: SmeeY 12 OT aL <br /> cmle- $T^Y z n <br /> OWNER PHONE: of <br /> OWNER EMAIL: <br /> CONTRACTOR NAME; ST . <br /> CONTRACTORADDRESS: STREET <br /> C rTY SlAYE l ZIP ' <br /> CONTRACTOR PHONE: vi�5 C CONTRACTOR EMAIL. U Z M ��S l UJ �Prr/,,}' <br /> CONTRACTOR LICENSr#(REQUIRED)- CITY OF EVERETT HuStNCSS LICENSE#(REQUIF�D) b`I � <br /> PRIMARY CONTACT: C7 OWNER CONTRACTOR ❑OThIER(Please Specify) 1, <br /> CONTACT NAMP: KCONTACT PHONE:CONTACT EMAIL; �j1�✓V�`I�S �s1 UJ I \,�Q�, �/6 <br /> BUILDING PERMIT APPLICATION <br /> E <br /> xisting Use of Building: J Contract Price of Work:$ <br /> d We of Build! 1•leat Source; as ❑Electric DOlher <br /> Type: FR-Dataohed ❑SFR-Attached LJDu 10X 0Multl-Fam1l -#of Url[ts ❑Commerclal Cllndustrlal <br /> Type of Project: ©New OAddition l7Remadel a<gepalr QT.). []Sign C]S rinkl®r MDemolltlon ©Change of Uae <br /> DESCRIPTION OF WORK: <br /> LAJ <br /> ASSOCIATED BUILDING PERMIT# Irapplicable); <br /> MECHANICAL PI49M1T AIPPILICAII' oN PERMIT APPLICATION <br /> Type of Project: _Ngw_ Addn _.Alteration _Rcpalr Ty of Project: _New ddn -Alteration _Repair <br /> FJ uof <br /> Ust of 1=lxtures f/xtu f Llet of Fixtures Flx u f L/Bt of Fw,tlra, Ff�r[ur Llst of Fbrfu s <br /> AIG-Alr Handt UnILs Heat Ptimp Toilet Ckflow Preven InstdB Bldg <br /> Forcad Air S statue Unit Heater Bathtub UNI <br /> Gas PI In Boller Lavato Wash Besln Drin Foufiialn <br /> Water Heater Refrigerationi Shower door Nrwfi <br /> Gas Flre lace Wood Stove Kitchen Sink&Ola oral Gree Tr <br /> Gaa Range Ducting Dlshwasher R_qdT Drains <br /> Clolhea E)ryer Hookups Other: Clothes WasherIle edicaj Gao <br /> Range Flood Water Heater Other: <br /> Exhaust Fan Sink Service/bar/Mo /etc, Other <br /> Sp1I21N Qsslo brut I <br /> omlcal or W of Heads <br /> ACKNOWf FOGEM�N7:I have mvrewod INS appllcatlon end confirm the Mrormallori conlafned herein In true and correct Work done pursuant to this permit must comply with <br /> curfwM Federal,sfefa,and local law_The granting of a permit only aulhorizes approved worn end no devieflons 6wrefrom,oev/allons must first be eufhorked In writing from the <br /> Bedding ORlclal before betng authorized under any c/reumstence.i am the owner,orl am authorized by the owner of this property to parmrm rho worn for which appl(catlon 16 m9da, <br /> end I comply with tha State ConlractOrs LaW 18.27 RCW and 296,200A WAG <br /> C1ty of Everett Offfcral use Only <br /> �41 I PER <br /> ,a < <ags- oak <br /> Own uthot,ze Ag 8lgnaturo oats (RovfsedWZ12016) <br /> i <br />