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09/05/2017 TUE 12: 06 FAX Fast Water Heater 1004/005 <br /> i Dii 30 6 <br /> PERMIT APPLICATION <br /> ef'......g,.... - BUILDING /MECHANICAL./PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> � _ CITY OF EVERETT PERMIT SERVICES <br /> " 3200 CEDAR STREET,EVERETT,WA 90201 <br /> (P)425-257-8810 I FAX 4.25-257-6657 I(E)everetteps(8�everellwa_gov I www.everetlwa.gov/permits • <br /> (Blue or Black Ink 0n1 Please) - PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: .31 1 Alpo 6A AyPROPERTY TAX#: D q O b DOV <br /> LEGAL for new construction: Snort PlaVaubdivieion Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: A a/ ALA ASA de �: TENANT NAME If Commercial): <br /> OWNER MAILING ADDRESS:m STREET 4-3) ► !C TAW A (� <br /> oily Aw srA .- - 1 ZIP' ( <br /> OWNER PHONE:_ -'25-1-12 -1.41.L..9.:—,--.QOWNER EMAIL: �! <br /> CONTRACTOR NAME: ?A ST tiki A' 1� �'�A"1-- / - <br /> 5 <br /> CONTRACTOR ADDRESS amaor \\' r 15- N C/Y'e e_ ft...JAM S =1 C 1)co 0� /� <br /> ewe J O��i L L srA•m f Aji `�� ` S.D 11 <br /> CONTRACTOR PHONE: (---1251g'l2s , O v+ _CONTRACTOR EMAIL: 2' R.Vn ITS Vv S}0u0000(vuo . GSM <br /> CONTRACTOR LICENSE#(REQUIRED)='F�t S vo 1-1 ct�g ,C I CITY OF EVERErF BUSINESS LICENSE i!(REOUIRED)5)453 <br /> PRIMARY CONTACT: 0 OWNER (CONTRACTOR D OTHER(Please Specify) <br /> CONTACT NAME: �/ V CONTACT PHONE: LI P-5- <br /> 'J r• `�,- <br /> f�14� 1� -N� - !CONTACT <br /> EMAIL: 9e ,11-S •'v 14 fir111.QDir. <br /> BUILDING PERMIT APPLICATION _ <br /> Existln, Use of Sulldln•: k Contract Price_of Work:$. l _. c <br /> Proposed Use of Building: ab Heat Source: XGee DElectrlc ©Other -*- <br /> Building Type: P"FR-Detached a SFR Atteohed ElDupiex IiMulti-Famliy-#of Units: _ DCommerclal Dindustrial <br /> Type of Project: ONew ❑Addition C1Remodel (Repair CIT.I. EISIgn CDSprinkier ClDemolltton DChange of Use. <br /> DESCRIPTION OF WORK; <br /> ftirn p\le / Ire \A•Ce iR-S w mak- \A ea," <br /> ASSOCIATED BUILDING PERMIT# If eEplioebie): _ . _ a� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projeot: _New _ Addn JAlteretton TRepair •a of P • - t: _New Addn _Alteration __Repair <br /> • <br /> Fixtures <br /> List of FixturesFixturesLfat of Fixtu es Fixtures LIel of Flxtu Fixtures List of Fixtures <br /> A/C—Alr Handling Unita Heat Pump T.let 4 Backflow Prevente • •Ida Bldg) <br /> Forced Air Systems Unit Heater B:,htub Urinal - <br /> Aft Gas Piping Boller La atory(Wash Basin) Drinklnt F 'Main <br /> 1 +� Water.Heater Refrigeration . Sh•,wet Floor r,, =1n <br /> Gas Fireplace Wood StoVe Kit en Sink&Disposal .. -ase Trap <br /> Gas Range Ducting Dish asher -oo ' eine <br /> Clothes Dryer Hookups OtherCloth Washer. Medical <br /> Rann a Hood Water eater Other: <br /> Exhaust Fan Sink 1S= Ice/Bar/Mo.'td;) Other: <br /> $. ,�-Man..--. - - . /31310 I. : ;.�- <br /> t Lam`'-- • of Heade - - <br /> _ .: - <br /> ACKNOWLE1GEMt NT:I have reviewed this application and mann die information contained herein ie true and correct.Work done pursuant to this permit must compfy with <br /> current federal,stele!end local law.The granting of a permit only authorizes approved worn and no deviations therefrom.Deviations must first be authorized M writing from the <br /> Building omelet before being authorized underany circumstance 1 em the owner,or lam authorized by the owner of this property to puform the worn for which application la made. <br /> and I comply with the State Contractors Law 19.27 RCW and 290.200A WAa <br /> city of Everalt Official Use Only <br /> :a'., q....5-,19, PERS — c 2` •; <br /> Own uthor za Ag Signature Date (Rebleed 9/23/2016) <br />