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08/29/2017 9:54 AM FAX 4258671555 ALLCLIMATEHEATING f� 0002/0002 <br /> PERMIT APPI.ICA710� <br /> BUII.DIN�ECH�INICAL/ PI.UMBtNG/SIGN /SPRINKI.ER/i]�MOLITION <br /> CITY OF�VERETT P�RMIT SE�2VECES <br /> 3200 CEDAR STR�ET,�VER�TT,WA 98201 <br /> (P)425-257-8$10 � FA?(425-257-8857 �{E j everetteps�everattwa.gov� www.evereffwa.gov/perrnits <br /> (Blue or Rlack I�k 4nly Please) �ROJECT SlTE�INFORMA7'�ON <br /> PROJ�C'i'SITE AbpRESS: 1 3 I '��p�' <,-a-. S VJ PROPER7Y T'AX#: C.( <br /> lECAI�for�ew canstruction: Sho�t Plat/subtiivision Lat No. (attach copy of long lagal descriptlon) <br /> CONTACY' IN�ORMATiON <br /> OWNER NAM�: ( u���i\ 7�NqNT NAME{If Commerciaf); '� <br /> OWNER MAI�.ING ADbRESS: srneEr � ` � ,S'�•. S , <br /> GI7Y �j V .� �� STA7� ZIP <br /> OWNER PHON�: ��j'�J�}'�"' ��-.�' { OWNEI�EMAIL: 1�I� (/l � 1�'C�c�'���C�i-� C.l�►'�',f <br /> CONTRACTOR NAME; . C�( •�-�_ � �; <br /> CQNTRACTOR ADDRESS: sTa�er� a� � �p�' �• �� <br /> ciYY � � <br /> STATE ZIP <br /> CONTRACTOR PHON�: ��j �-'ii(p r '�j '�-' CONTRACTOR EMIAIL_ �„�yyy� • � ��.�t��t��j1 .�-f--- <br /> COIYTRACTOR LICENS�#�(REQUIRED): ��.0 LC G� CITY OF EV�R�Ti'BUSIN�SS LICEf1SE#(R�QUIRED. <br /> RRIMAaY GONYACT: G]�WNER CONTRACTOR ❑O7HER(Plesse Speeifya <br /> CONTAC'�IVAN�E: GONTACT PMON�: �� � ' C��..���� <br /> r \ �V� CONTACT�MAIL: <br /> Bu�LpING PeRn�1T APp��caT�pN <br /> �xistin tJse of Buildin : Contract Price of Worl�;$ <br /> Proposed Use of Buildin : Heat Sourco: as �lectrfc ❑ her <br /> Buildin Type: ❑SFR-Detaahed FR-Attached ,ODuplex 17Multl-Famil �#of Units: ❑Co mercial ❑Industriaf <br /> T e of Project: dNew �Addition� Remodel ❑Repair ❑T.f. OSi n ❑Sprinkler ❑ molitio (�Change of Use <br /> DESC fPTiON OF WORK: <br /> �U � �11� �._ �S�G�. ( � � <br /> ASSOGA7ED BUILDING PERMIT# If applicable: <br /> � MECHAN[C4L, PERMI7 4PPLICpT10N PLUMBING P�RMlT APPLICATION <br /> rype vf proJect: _New „ Addn Alteratlon _Repair Type of Pro)ect: New „Addn Alteration _Repalr <br /> #of L�gt vf F/xturas #of #of � <br /> Fixtures plxh,� Llst of Fixtunes Fi,ctures Llsf of Ffxtures ' �°f List of F/xtures <br /> flxtures <br /> A/C-Air Handling Units Heat Pump �oilet 8ackflow Preventer Insid�Bldg) <br /> ForCed Air Systems t� Unit Heater Bathtub Urinal <br /> - Gas Riping Bailer L.avatory(W2sh Basin Drinkin Fount2in ' <br /> Water HeaEer aefri Erakian 5hower Floor Drain <br /> Gas Fireplace Wood StoVe �i#chen Sink R Disposai Grease Trap <br /> Gas Ran e bucting Dishwasher Roof Drains <br /> Clothes D er Hoakups Other: Clothes Washer Medical Gas <br /> Ran e Hood Waker Neater Ofher. <br /> Exhaust Fan Sink(Service/Bad1Ulop/etc. Other <br /> SPRIN�LER/SUP`PRES$�ON SYST�M <br /> Che c I or Water No,of Heads <br /> ACifNowLEDG EN ;/have reviewed this eppli�rion and confirm the infamafion contained hereln!s truo antl cvrrect.Work dona pvrsuant to tnis permit must comply with <br /> cu�rerrf federal,s�ate, �1B loCal law.Tha grentiRg� a poPmit onfy aufhodzes aAAroVed wofic�nd no tlevia6ons therefrom.DBviatlo/7s 111Usf rrs!be autharized in writrng fr0li7 the <br /> Building Offlc/s4, o being euthorizeA�ndor any ircumstance.I am the owner,or I am authonzad by the owner of thls propedy to pe�famr the work for whlch appl;eation is mede, <br /> and I comply w;tli t Stai�e Contractors w 18.2,. W a d 266.200A WaC. <br /> f , <br /> , , ,� � . �,� .�� � Y C;[y 4f Everett OfliCia!Use Only <br /> : /01.��(� 7•• p� I # <br /> , <br /> f '�l � � � -05� <br /> �whe}/!lt3t orized Agent Sighature Data (Revlsed 9/23/2016) <br />