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PERMIT APPLICATION <br /> BUILDING I MECHANICALJ PLUMBING/SlGN/SPRfNKLER/DEMOLITION <br /> CITY OF EVERETT PERMIl'SERVECES <br /> 3200 CEDAR STREET,EVERETT,WA 9$2Q1 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> (Blue or Black Ink On1y Please) PROJECT SIT8INFORMATION <br /> PROJECT 51TE ADDRESS: 6Q.O5 C 1'@SS St PROPERTY TAX#: 00393400003600 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: MBttll@W CUCICJ�/ TENANT NAME(If Commercial): <br /> OWNER MAILlNG ADDRESS: srneer 6405 C ress St <br /> crrv Everett srA,� Wa z�P 98203 <br /> OWNER PHONE: 4Z5-3'I Z-H'I F)O OWNER EMAIL: <br /> - . . _........... . ..... . _. <br /> CONTRACTORNAME: BObS Heating <br /> CONTRACTORADDRESS: srReer 14148 NE 190th St <br /> cm woodinville sTATE Wa ZiP 98072 <br /> CONTRACTORPHONE: 800-840-3346 CONTRACTOREMAIL: lhoneycutt@bobsheating. com <br /> GONTRAGI't1Ei LICENSE#(R�C�UIR�D);BOB S HHAH 5 3NQ Gf'fY OF EVERETT BUSINESS L(CENSE#(REQUIRED). O 5 4 9 C 7 <br /> . _ . __ _ .. _ . ,. _,. . ._ __. _,._.,_ ._.__. . __.,t .__.._ ____.._.. ._ ._ _. ._ ... _._. _�.. _. _ <br /> PRIMARY CONTACT: ❑OWNER �CONTRAC70R ❑OTHER(Ptease Specify) <br /> CONTACTNAMEc Lucinda Honeycutt GONTACTPHONE: 206-37$-6735 <br /> CONTACTEMA��: lhoneycutt@bobsheating.com <br /> BUILDING PBRMlT APPLICATit?N <br /> Existin Use of Buildin : S FR Cantract Price of Work:$ 26��.�� <br /> Proposed Usa of Buildin : Heat Source: �Gas ❑Electric ❑Other <br /> Buiidin T e: ❑SFR-betached f�SFR-Attached ❑Du lex ❑Multi-Famif -#of Unfts: ❑Commerciai ❑Industrial <br /> T e of Pro ect: ❑New �Addition ❑Remodel 11�Fte a(r �T.I. 'L7Si n ❑S rinkier ❑Demolition ❑Chan e of Use <br /> DHSCRIPTION OF WORK: 1 e or i e urnace rep acemen <br /> A330CIATED BUILDING PERMIT# if a licable: <br /> MBCHANICAL PBRMIT APPLtCAT1�1N PLUMBING PERMIT APPLICATION <br /> Type of Project: New_ Addn _Alteration _Repair Type of ProJect: New Addn _AlteraUon _Repair <br /> #of Llsf of Ffxtures #of Vy.�of Flxtures #of Lfst of Hxtures #of Llst of Flxtures <br /> Flxtures Flxtures Fixtures Fixtures <br /> A!C—Air Handlfn Units Heat Pum Toilet Backflow Preventer lnslde Bld <br /> FtirCed AIC S ste�is �lnft Heater Bathtub Urinal <br /> Gas Pipin Boiler I:av�tory(1Nash Basin Drinking Fountain <br /> Water Heater Reni eration Shower Floor Draln <br /> Gas Fire lace . Wood Stove Kitolt�n Sink&t�€s sai Grease Tra <br /> Gas Ran e Ductin - Dishwasher Roof Dra(ns <br /> Gl4thes D er Hca�aku Qther. Clothes Washer Medical Gas <br /> Ran e Noad Water Heater Other. <br /> Exhaust Fan Sink Se.tvicelBar/Nto skc:. Other: <br /> SPR(NKLBR/SUPPR�SSIIaN SYST�M <br /> Number of Heads <br /> ACKNOWLEDGEMENT.�!heve revlewed this appNcallon and conflrm the informatlon contalned herein ls Mue and coireck Work done pursuanf!o fhls parmit must comply wlfh <br /> current lederal,stafe,end Poca!law.The grenting of a permlt only authorizes approved work and no devlaHons fherefrom,AevJations must flrst be aufhorized in wrlt/ng/rom the <br /> Bu/IdTng Offic/el bePore being aulhodzed under any c/rcumstance,I am the owner,or I am authorized by the owner of this properfy to pertorm the work for whtch applicatlon Ts made, <br /> artd!com ly with the State Contrecto Law 18.27 RCW and 298.200AWAC. <br /> C!!y of Everett Off/cta!Use Only <br /> PERMI� 1.�� � M �— ):J � <br /> /Authorized Agent Stgnature Date (RetilsoC5J2Zt12a78). <br />