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12/01/2017 FRI 9: 25 FAX Fast water Heater U002/007 <br /> ' gob 385- <br /> PERMIT APPLICATION <br /> iliAlr <br /> BUILDING /MECHANICAL / PLUMBING /SIGN /SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)428-2578810 I FAX 425-2573867 I(E)everefteps ovorettwo.gov I www.everettwe,gov/per nUta <br /> Biota or Black Ink Only Please) PROJECT SITE INFORMATION U I i <br /> PROJECT SITE ADDRESS: 418-161 oily V 1}) L/L PROPERTY TAX#: Oh-I/ III,. I All <br /> LEGAL For new construction: Short Plat/aubdIv(slon _ Lot Nom (attach copy o(I❑ng Togo'description) <br /> CONTACTINFORMATION <br /> • .. <br /> OWNER NAME: a 1 g 1� JJv R 5L,, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS; Wirer 1451 -1 `1UI f U.l (, Kf _ <br /> CRY V n '..i 9YATE V l _ ZIP `�/l\ <br /> 4 <br /> OWNER PHONE: 5-, 5-5-qd -a' OWNER EMAIL: - �J <br /> ,c)- <br /> CONTRACTOR NAM~; f�S-1- \A)AY � 0 L�Tj <br /> CONTRTORADDRESSVt <br /> S 54 (F I Dtp <br /> 11 cif, Z I i^ 1.et ' &TATE IA f h- 2IP d D\ \ <br /> CONTRACTOR PHONE: L-0 S to- U.-"+-01C CONTRACTOR EMAIL:CI VYl CTS SA-1,14 y ,--Y-4-. (,,(N1 <br /> CONTRACTOR LICENSE#(REQUIRED):f -S-rimA. r q '� CITY OF EVERETT BUSINESS LICEN (45-3SE#(REQUIRED)5D <br /> CONTACT: 0 OWNER, CONTRACTOR 0 OTHER(Please Specify) _ <br /> CONTACT NAME: V CONTACT PHONE: LI OS- 3L D S-1- <br /> l�/�/�r —�I v� CONTACT EMAIL: e/IrVV1��"I"� 1(`t�'�VJ/� 'kTyr , t/� <br /> EiIJILDIIIIG PERMIT APPLICATION <br /> Exlstiny Use of Building: Contract Price of Work:$ � <br /> Proposed Use of Building: Heat Source: Qae ❑Electric Mother <br /> Bultding Typo: OFR-Detached LI SM-Attached ❑Duplex 0Multl-Family-#of Units: ❑Comrnerolal ❑Industrial <br /> Type of Project: ❑Naw ©AddiUUon ❑Remodel t�Repalr LT.i. DSIpn ❑Sprinkler DDemolltlon ❑Charge of U3e <br /> DESCRIPTION OF WORK: <br /> ' ova / Ce 0 A-C e_ EZAS w -e'r- 1� e a,t- - <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMWNG PERMIT APPLICATION <br /> Type of Project: _Now Aden Alteration _Repair Type of Project: _New Addn __ Alteration Repair <br /> Fixtures List'of Fixtures Fixtures of Fixtures Fixtures List of Fixture Flxhtur s List of Fixture- <br /> A/C-Alr Hendllnsi Units w -Hoot Pump Toilet Backflow Preventer side Bldg) <br /> r Forced Air Systems - _ _Unit Heater • Bathtub • Urinal <br /> N. Gas Piping _ Boller Lavatory(Wasli Basle) Drinking Foun : n <br /> • <br /> w Water Heater Refrigeration Shower Floor Drain <br /> Gas Ftreplace Wood Stove Kitchen Stnk&Disposal _4 ;ase op _ <br /> Gee Range Duoting _ - - Dishwasher Ro RI ales <br /> Clolhee Dryer Hookups _ Other: Clothes Washer _ -dict Gas <br /> Range Hood Water Healer either: <br /> Exhaust Fan Sink(ServIce/Bar/Mop/etc.) Other: <br /> SPRIPI I~SSIo_mY-STtM - <br /> I emlcal ar W ,of Heads <br /> ACKNOWLEDGEMNT:/have reviewed this application and confirm the information contained heroin is true and correct Work dons pursuant to this permit must ccmpiy with <br /> currant lederei,slate,and loch/law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first Po authorried m writing(rem the <br /> Building Official before being authorized under ony circumstance.1 em the owner, ori am authorized by the owner of this property to perform the work for which application le made, <br /> end I camply with the Slate Contractors Low 1E1.27RCW and 29e•?0OA WAC. <br /> City of Everett Official Use Only <br /> D / 1 � ' ) <br /> ' FERMIT# \_1 00 <br /> Own uthor z y $terleitrre Beta (Revised./ 2 18) ' <br />