Laserfiche WebLink
12/05/2017 TUE 13: 42 FAX Fast water Heater 0008/008 <br /> K-6iô5 <br /> PERMIT APPLICATION <br /> BUILDING 1 NIECI-IANICAL/PLUMBING / SIGN /SPRINKLER 1 DENROLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 38201 <br /> (P)425-257-8010 I FAX 425-257-8867 I(E)everettepsaeveretiwa.gov I www.everettwa.gov/permits <br /> (Blue or slack Ink Only Please) PROJECT SITE INFORMATION } <br /> PROJECT SITE AUDRE5S: 'qL ag Se U � BLUfl PROPERTY TAX#: t4Q 1 OI <br /> LEGAL for now construction: Short Plat/subdivision Lot No. (attach copy of long legal description) if <br /> CONTACT INFORMATION• - <br /> OWNER NAME: er ,.V 1L) . TENANTrNAME(If Commercial): r�� <br /> OWNER MAILING ADDRESS: STREET id-(J trI�Cl" �!VY I i s.VP <br /> CITY Af•�l 11 STATE i 21P <br /> OWNER PHONE; L69s F-37) 00 TOWNER EIVIAIL: --- <br /> CONTRACTOR NAME:CONTRACTOR ADDRESS: S emu A-1. ...v., <br /> ���T � <br /> crN 'k1 Ir./Ai-.,.1,-L.- aTATE LA), YIP 1 0 ' 'Q <br /> CONTRACTOR PHONE: fps .Lp D`l • CONTRACTOR EMAIL:P e I-T Sp s -)ote li uAppeA • (Ail <br /> l <br /> CONTRACTORLICENSE#(REQUIRED):IAS \JO r 1 3'130 JCITY OF EVERETT BUSINESS LICENSE#(REQUIRED)b b"153 <br /> PRIMARY CONTACT: D OWNER (1CONTI',ACTOR 0 OTHER(Please Specify) - <br /> CONTACT NAME: 1 CONTACT PHONE: 0'S f -3L,Lj V l <br /> \(/4-113Y,�\4v" CONTACT EMAIL: P' NI,its P i 1 •v- £t A.JI.e-ir, CAW <br /> _ _ BUILDING PERMIT APPLICATION <br /> 'P Existln9 Use of Building: . S Contract Price of Work:$____________________________________ <br /> proposed Use of Building: 5FA_.. Source: (pas InElectrIc ElOIher <br /> ,Oullding Type: SFR-Detached °SFR-Attached- ODuplex DMultl-Familx-#of Unita: °Commercial Dlndustriai <br /> Type of Project: °New °Addition C]Remodel agtileRalr, UT.I, USIgn OSprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORk: - _. <br /> 1:\A/. l rreLOA-Ce GI FS <br /> M-•elr V\ e,a,--t <br /> ASSOCIATED BUILDING PERMIT#(If applicable), <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type oP Project; ,NaW Addn Altaratlon Repair Type of Project New />ddn _AI tereiion _Repair <br /> F � <br /> WE of Fixtures -Pi xtur� List of Fixtures Frxfurea List of Fixtures F of <br /> List of F urns • <br /> NC—Air Handling Unita Heat Pump _ Toilet Backflow Prsv-nter(Inside Bldg) <br /> Forced Air Systems Unit Healer to. Urinal <br /> .. 0Das Piping Zoller Lavatory(Was r:sin) Drinkln! Fountain <br /> Water Heater Refri!eratlon Shower Floor' alit <br /> Gas Flrepleoa Wood Stove 'Kitchen Sink&Die•os= 0 :=se Trap <br /> Gas RDucting DClothes er oof prams <br /> Clothes Dryer Hookups — , Other -Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: _ <br /> Exhaust Fan Sink(Service/Bar/Mopiefc, Other: <br /> . . SPRIN e89I2sY-8MT - <br /> emicel or W y. .of Heads <br /> ACKNOWLEDGEMr1NT:I have revlawed this applfcallon and confirm the lnlarnallon contained herein le true and correct.Wad(dons pursuant fa this permit must comply with <br /> Durrant federal,state,and local law.The granting of a permit only authorizes approved work and no devlef/one therefrom.Deviations must first De authorized in writing Rem the <br /> Bullding Official Mare beMg authorized under any circumstance I am the owner,or I em authorized by the owner of this property to perform the work for which application Is made, <br /> and I comply wish the State Contractors Low 18.27 PCW and 29e200A WAG. <br /> City of Everett Official Use Only <br /> Own r ulhor ze Ag signature v Date (Re Weed 9/2a/2016) <br />