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06/01/2017 THU 16: 25 FAX Fast water Heater 0005/006 <br /> 0aldil <br /> • PERMIT APPLICATION <br /> BUILDING /MECHANICAL./PLUMBING I SIGN/SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> • 4,177. 3200 CEDAR STREET.EVERETT.WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(2)everettaps®everettwa.gov I www.everettwa.gov/permfte • <br /> Blue or Black Ink Only Please) PROJECTE SITINFORMATION / <br /> PROJECT SITE ADDRESS: t1[Q'33 g(i1W D75 t. PROPERTY TAX#: OD/LI a d 1)06f J0a! <br /> LEGAL for new construction: Short Platioubdlvfelon Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: r AoL i 1✓ TENANT NAME(If Commercial): ...„....—.- <br /> OWNER <br /> --"—!OWNER MAILING ADDRESS: sumer (1 3 . - Li 1* Dia s - q <br /> Mr Y V 6«' — 9rATEw.�- ZIP 8?Z 8 <br /> OWNER PHONE: OD 1p 11,2 1p 10 + • <br /> OWNERnEMAIL: <br /> CONTRACTOR NAME: fA Si" i ft)FAS g. 1'1�f�-1•/'C. <br /> CONTRACTOR ADDRESS: STREET \f 1"'I'5 IQ VQ Q4, re y }�.{ S 11 <br /> sr_ t,/ i _i, STATE LA/ ' ZIP ' , b k <br /> CONTRACTOR PHONE: (-12 s 1_031 Thnkik CONTRACTOR EMAIL:P- VI11T S 6 / A-vJallex t a-c'r. tow' <br /> CONTRACTOR LICENSE#(REQUIRED):�A'Srw �� •$•� f CITY Ot=EVERETr 8USINES�LICENSE#(RI�QUIRED)•. 453 <br /> PRIMARY CONTACT: Ll OWNER (CONTRACTOR D OTHER(Please Specify) _ T <br /> CONTACT NAME: -y CONTACT PHONE: LIPS- i' '3L 1/I <br /> \ <br /> :ATkj �it"1 G CONTACT EMAIL: R evt-11-S&_,R.&�WkeArtel i. X, U5yvi <br /> BUILDING PERMIT APPLICATION _ rr <br /> ``� Existing Use of Building: .7 Contract Price of Works 1 (�k <br /> Proposed Use of Huild)ng: Heat Source: 44as DElectric DOlher r. <br /> Building Type: FR-Detached CISFR-Attached ❑Duplex DMultl-Family-#of Units: OCommerclal Dlnduatrlat <br /> Type of Project: L iNew GAdditlon IjRernodei Repair_ DTI DSIgn ._DSprinkler DDemolltion DChange of Use <br /> DESCRIPTION OF WORK: <br /> vino\je., ! r e,p\ c,e C1 S J a.A-ter \A c o - ' <br /> ASSOCIATED EUILDINt3 PERMIT#(If. h...: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration Repair Type of Project: New - ".Addn _Alteration pair <br /> FixturesList of Fixtures Fixtures List of Fixtures Fixtures • - 'ups Fixtures Lis f Flxturos <br /> NG-Alr Handling Units Heat Pump T. et Backflow P eventar(Inside Bldg) <br /> Forced Air Systema Unit Healer r:ethtub Urinal - <br /> 0111160 <br /> Gee PipingBoller 4Lavatory(Wash Basin) Drin g Fountain <br /> WaterHealer • - Refrigeration Shower F r Drain <br /> Gas FireplaceWood Stove Kitchen Sink&Disposal r Grease Trap <br /> Gas Range Ducting Dishwasher - oofi Drains <br /> Clothes Dryer Hookups • Other: Clothes Washer ...el Ical Gas <br /> Range Hood —L= _ _ _ — .� <br /> 'ExhaustFanIIIII 8 -- :ariMap/stc.) Other. <br /> SPRIN I.Eii' RSSIOSTPM _ _ <br /> •lomtoai orW I ..of Heads • <br /> ACKNOWLEDGEMJIr I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this pennit must comply with <br /> current federal,Sala;and local law.The granting of a permit onty authorizes epproved work and no devisllone therefrom.Gevhrtions must first be authorized In writing item the <br /> Bulking off/met belbie being authorized under any circumstance.I em the owner,art em authorized by the owner of this property(o penbrm the work for which application is made, <br /> end i comply with the State Contractors Law 99.27 RCW and 2001200A WAG. <br /> / (.0 <br /> I / City of gvereltOfllclsi Us/e�Only, I ", ✓ 1 1 PERMIT* V l L/ b , . <br /> • <br /> Own' uthorze.Ag, Signature Date (Revise�� �312OIN , <br /> 1 <br />