Laserfiche WebLink
09/05/2017 TUE 12: 05 FAX Fast Water Heater Z002/005 <br /> ...-�.......-�• ern.. .,,1•Pr....A. . -• <br /> • <br /> PERMIT APPLICATION <br /> �/" BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER I DEMOLITION <br /> WY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EvERETT,WA 98201 <br /> (P)425.257-8810 I FAX 425-257.8857 I(E)everettepsneveretlwa.gov I www.averettwe-gov/perrnIts <br /> (Blue or Black Ink Onl Please) PROJECT SITE'INFORMATION n CO• <br /> PROJECT SITE ADDRESS:. 314°P G,A L Re PROPERTY TAX#: 66, Ob, 1&D, O V <br /> LEGAL for new conairuotlon: Short Plal/subdIvlslok Lot No.__„ (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: AV NS-• P TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: smear a 5 i- (-7/1.L'�. .p� � / <br /> Cr1Y 'A T STATE kik <br /> I /]. v,y AP. 18.R <br /> OWNER PHONE: 105 . , , OWNER EMAIL: llf <br /> CONTRACTOR NAME: fA Si" i&I AsI le, l-1/4-e--A1- _ <br /> CONTRACTOR ADDRESS; STREET 1 0.... � <br /> - 1ritY Y� f__S <br /> Crit 'kJ .IA4 1.,_1_, STATE Loki A 211' g g'D `I <br /> CONTRACTOR PHONE: !6 2 5 IQ j CONTRACTOR EMAIL:P.evil a S p--Ashoote.,,t-vs_meir. (Wi <br /> CONTRACTOR LICENSE#(REQUIRED):l,4'S ) }\-1-q1-1(3 Bc CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)5o 1453 <br /> pRIMARY CONTACT: in OWNER (CONTRACTOR 0 OTHER(Please Specify) _ <br /> CONTACT NAME: CONTACT PHONE: LI P5 isd '7)L.40 ' <br /> .41j L CONTACT EMAIL: 1'i/( 'I ., Dt ` , C' <br /> BUILDING PLRMiT APPLICATION 7 <br /> Exlstingpse of Building: sf, Contract Price of Work:$ ,`�1 r.D — _� <br /> aProposed Use of Building:_ - Heat Source: L It as tIectrtc ElOther <br /> Building Type: ISLaFR-Detached IJSFR-Atteched ©Duplex CiMultt-Family-#of Unite: ❑Commerclal EJindustrial _ <br /> Type of Prroect: 1:/New ClAdditlon ClRenodel kfRepatr DTI. ©Sign DEprinkier DDemolltlon OChang!of Use <br /> DESCRIPTION OF WORK; <br /> f VYI 0\1e., / re,i)\ACe keCt if i G L )c k C O <br /> ASSOCIATED BUILDING PERMIT*(If applicable): , <br /> MECHANICAL PERMIT APPLICATION_ PLUMBING PERMIT APPLICATION <br /> Type of Project; _New _ Addn _Alteration _Re air Type of Project: flew _Addn _„Alteration Repair <br /> _ <br /> #of LW of Ffxturee °f Lis Fixtures #of List of Fixtures• ft of <br /> List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> C-Alr : • ng Unitsat Pump Toilet ...Backflow Preventer(Inside 131dg) <br /> arced Alr Syste Unit Heater ' _ BathtubUrinal <br /> -as Piping . Boiler Lavatory(Wash Basin) Drinking Fountain <br /> 1 pier Heater. Refrigeration Shower :Floor Drain' _ <br /> e,. Fireplace Wood StoveKitchen Sink&Disposal Grease Trap <br /> c:; Range Ducting .. Dishwasher Roof Drains <br /> Clo •,a D et• okupsbkhc. 4,„ Clothes Washer. Medical Gas <br /> Klan e -.•d _. h ®,Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/e1c,1 Other: <br /> • <br /> sPRIN BR- SSIO S 1 <br /> em I or 1 .of Heads <br /> ACKNOWLEDGEkONT2 I have reviewed this eppllee and confirm the Information contained herald Is true end correct.Work done pursuant to firs perm/t must comply with <br /> current federal,stater ena(coal law.The granting of a permit only suthodzes approved work end no deviations therefrom.Deviations must/Jilt be aufhor/Yed rn writing nom the • <br /> Building mist before being authorized under any circumstance.I am the oWner,or I am authorized by the owner of this property to perform the work for which application Is made, <br /> and I comply with fee State Contractors Law 18.27 ROW and 29e 240A WAC. <br /> City of Everett Official Use Only ' <br /> i <br /> PERMI # • <br /> ..1 I J q.....6-_, I J —IIV�i'® <br /> Own ether ze Ag Signature Date (Revised e ie) ' <br />