Laserfiche WebLink
05/23/2017 WED 14: 40 FAX FaAt Water Heater 0006/008 <br /> PERMIT APPLICATION <br /> BUILDING I MECHANICAL/PLUMBING 1 SIGN/SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425.257-a8l0 1 FAX 425-257-0857 1(E)everotteps®everetlwa.gov J www.everellwa.gov/Permlta <br /> Blue or Black Ink Only Please) PROJECT SITE INFORMATION / <br /> rv) 00 <br /> PROJECT SITE ADDRESS: KZ) PROP>;RTY TAX#: C <br /> LEGAL For new constructlon: Short Plat/subdlvlsloh Lot No. (attach copy of long legal dascrlptlon) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commerclal): <br /> OWNER MAILING ADDRESS: STREET 1 <br /> city STATE L-b/-A ?JP <br /> OWNER PHONE: OWNER EMAIL: �- <br /> CONTRACTOR NAME: EAST r <br /> CONTRACTOR ADDRESS: STREET s E l <br /> crrr WATE l zi 1 <br /> CONTRACTOR PHON>=: �-pS � CONTRACTOR I_MAI1.; <br /> CONTRACTOR LICENSE#{REQUIRED): S 0\1 CITY OF EvERE7T aUSINESS L.IcENSE#I(REQUIRC-D)• <br /> PRIMARY CONTACT: C1 OWNER (CONTRACTOR ©OTHER(Please Specify) _ <br /> CONTACT NAME: n CONTACT PHONE: aS <br /> CONTACT EMAIL: Vl/l <br /> BUILDING PEWAIT APPLICATION <br /> Exiot(n Use of�Buildin �T- Contract Prlca of Work:,$ <br /> Pro osed Use of Sulldln Meat Source: ©Gas Electrlc DOftter <br /> Bulldln e: FR-petach®d CISFR-Attached ODu lex L1MulfJ-Famll -#R of Units: IlCommerclal ©lnduetrlal <br /> 7 o of Pro eok ONow ❑Addltlon L]Remodel R® nlr M71. MSI n ❑S rinkler MDemolltlon ElChange of Use <br /> )DESCRIPTION OF WORK: <br /> w01- afi <br /> ASSOCIATED BUILDING PERMIT# If a Itcable : <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJeat: _Naw Addn _ AItef9tlon ___Re Typo of Project: _New ___1tldh __Altoratton _Rspelr <br /> Wxturea sf oof f Flxluree Fl ur@g Lls f Fixtures F lu As I fst of Fixtures �1 �o S Ust of Ftxturos <br /> —Alr Handlin Unlf et Pum Toilet Backflow Preventar Inside Bldg <br /> orcad Air S etems nit Hoater Bathtub Urinel <br /> Gae PI In Boiler Lavata Wash Basln Drinkln FOuntnln <br /> Water Heater Refrl eratlon Shower Floor Draln <br /> Gas Flre lace Wood Stove Kitchen$Ink&Dle osal Grease Trap <br /> Gas Rene Ductln Dlshwas er Roo Drains <br /> Clolhes F)ryer Hoo s Othor: Clothes Washer . Medloal Gaa <br /> Ran s Flood Water Heater Other: <br /> Exhaust F Sink Servlce/Bar/Mo /etc. Other: <br /> SERIN �8$I O 1VI <br /> ®mlcal or W of Heade <br /> ACKNOWLEDGEWEM''(have revlawed thls appllcatlon and coM7im the Informallon cont$lned herein Is frua end correct. Work dono pwsuont to this permit must comply with <br /> Curren!federal,state'end focal law.Tho gfaning of e pormtt only authorizes approved work and no devlallons therefrom.Devlalfons must Ilrs!be aufhorized In wNting from the <br /> Hullding oflwal before being aulhorhsd undorany clrcumalsnce•I em(he ownar,or f am autharizad by the ownar of IRIS proparfy(o perform the work forwhlch appllceifon is made, <br /> and I comply wlth the Slate Conlractors Law 78.27 RC W and 28B.2G4A WAr- <br /> City of 15berett off/G1,91 Use only <br /> a PERNM <br /> own&TKuthor ze Ag Stgnatura Date (Rev/aed 9/23/2019) <br />