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PERMIT APPLICATION <br /> BUILDlNG I MECHANICAL/PLUMBING 1 SlGN /SPR(NKLERl DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEbAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)evere#teps@everettwa.gov� www.everettwa.gov/permits <br /> (Blue or Biack lnk Only Please) PROJECT SITE INFORMA710N <br /> PROJECT SfTE A�DRESS: 2 015 113th Pl SE PROPERTY TAX#: <br /> LEGAL for new construction: Short Platisubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNERNAME: BrUC2 Tschider TENANTNAME(IfCommercial): <br /> OWNERMAILINGADDRESS: srr�e�r 2015 113th Pl SE Everett, Wa 98208 <br /> c�rr Everett srn-r� Wa zia 98208 <br /> owNER PHONe: 4 2 5—7 6 6—8 6 4 0 OWNER EMA1L: <br /> CONTRACTORNAME, Bobs Heating <br /> CONTRACTORADDRESS: sraeEr 14148 NE 190th St <br /> ��n, Woodinville srnTe Wa ZiP 98072 <br /> CONTRACTORPHONE: 8OO—H4O-3346 CONTRACTOREMAIL: 1hOri2yCutt@bObsh2dti C�j.C0 <br /> Cqh1TFLqG't't5R LICENSE#{I�Et�tJif��D�:BOBSHHAH�J 3NQ �17Y OF EVERETT BUSINESS LICENSE#(REQUI �: 0 5 4 9 67 <br /> __ _ . .. ._ . _ . _ .. _ . .. ._ _ . _ __ _ _.. . _ . . . _. _ <br /> PRIMARY CQNTACT: ❑OWNER l$CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACTNAME: Lucinda HOri2�7Cutt CON7ACTPHONE: 206-378-6735 <br /> C�NTACT EMAIL: 1hOri2yCUtt@bObSh2atiriC�j.com = <br /> BUILDING PERM17 APPLlCA"f10N <br /> Existing Use of Building: S FR Contract Price of rk:$ 6 0 0 0 <br /> Proposed Use of Buildin : Heat Source: ❑ [�le ' Other <br /> Buiidin T e: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Pamif �of Units: ❑Commercial ❑Industrial <br /> T e of Pro ect: ❑fVew L�Addition �Remodel ❑Re air �T.I. ❑Si n ❑S rinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Add ductless heat pump <br /> ASSOCIATED BUILDING PERMIT# if a licable: <br /> MECHANIGAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_ Addn Alteration _Repair Type of ProJect: �New Addn _Alterafion _Repair <br /> �°f List of Fixtures #of t�sf of Flxtuies #of List of Fixtures #of List of Flxtures <br /> Fixtures Flxfures Fixtures Fixtures <br /> A/C—Air He�Itllin Units Heat Pump Toilet Backfiow Preventer Inside Bld ) <br /> - Forced A(r S stetns Unit Heater Bathfub Urinal <br /> Gas Piping Boiler Lav�tciry(VNash BasinJ Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace , Wood Stove Ki#chen Sink&�is nsal Grease Tra <br /> Gas Range Ducting. Dishwasher Roof Drains <br /> Gtathes� er Hooku s Other. Clothes Washer Medicaf Gas <br /> Ftar�ge Hood Water Heater Other. <br /> Exhaust Fan Sink �erviceiBariMnp/etc: Other: <br /> SPRINKLER/SUPPRESSId)N SYSTEM . <br /> Number of Heads <br /> ACKNOWLEDGEMENT.•I have reviewed this application and conflrm the information contained herein!s frue and correct.Work done pursuant to fh/s perrnit must comply wifh <br /> current Pederaf,sfafe,and local law.The granting oi a permlt only authorizes approved work and no deviations therefrom.Devlafions must frrst be authorized in wriNng from the <br /> Bui(ding Officiaf before being aulhodzed under any circumsfance./am fhe owner,or 1 am authorized by the owner of thts property to perform the work for whlch applicatlon is made, <br /> and i comply with he Sfate Confractors Law 18.27 RCW and 296.200A WqC. <br /> Clty oPEverett Ofllclal Use Only <br /> P�R� c�� --b� � <br /> 6/7/17 <br /> Owner/ rized Agent SlgnaEure Date (Reufs�d fiJ2b/20fi6J <br />