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08/23/2017 WED 14: 40 FAX Fast Water Heater i23004/008 <br /> I 0 g q'D5 <br /> PERMIT APPLICATION <br /> BUILDING l MECHANICAL.I PLUMBING/SiGN I SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> a 3200 CEDAR STREET,EVERETT,WA 90201 <br /> (P)425-257-88W I FAX 425-257-8857 1(E)everetteps@evereuwa.gov www.everetlwa.gov/permits _ • <br /> Lem ar 13Iaak Ink Only Please PROJECT SITE INPORIVIATiON <br /> PROJECT SITE ADDRESS: a i . (_:,0 v '3 PROPERTY TAX#: OD 00 P(. V <br /> LEGAL for new construction; Short PleVaubdlviaion _Lot No, (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: w , J �rh i/ j4oh TENANT NAME If Commercial : <br /> OWNER MAILING ADDRESS: smear , 0 / �( Fara <br /> CITY 11 4 ' STATE A. LP I •• ill <br /> - <br /> OWNER PHONE: ....i/ ! I . OWNER EMAIL: <br /> CONTRACTOR NAME; .iA ST i A / a-1`l;- f <br /> CONTRACTOR ADDRESS: erREET t a. �j N CXf e S C 1(�(„ <br /> - t {n CnY Z 011-11__L- 9YAlF VI,A- ZIP 9 'Q' <br /> CONTRACTOR PHONE: <br /> _l a�S to"3\2."+-0S11 CONTRACTOR EMAIL:Ev elm ITS v-rti,SA'11ACXri . omi <br /> CONTRACTOR LICENSE#(REQUIRED):' 1 j o\ iO j $(..., CITY OF EVERETT BUSINESS LICENSE ft(REQUIRED)57)(453 <br /> PRIMARY CONTACT: El OWNER ( CONTRACTOR 0 OTHER(Please Specityr) <br /> CONTACT NAME: CONTACT PHONE: LI 0gt <br /> \(41-13 � L (CONTACT EMAIL: p_eArvw,i-r5 de.3t..„ <br /> i/uG�.l�.i>"1 t s'. mil <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: - Contract Price of Work:$ <br /> plpposod Use of BuildtngL 4 re- }teat Source: !Gas Ieotric ©Other <br /> Building Type: LISFR-Detached ❑SLR-Attached DDuplex uitl-Family-#of Units: OCommerclal IJIndustriell <br /> Type of Project: ONew CDAddItton Oriel-node' CtiiRepair LIT.1. LiSIgn 1E1SprinklerCiDemolltion LIChange of Use <br /> DESCRIPTION OP WORK: - - <br /> inn n\1e / Ir21/4Q1 .Ce eAtc tr i L w 0 &v e a,-\-e_ <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION `- <br /> Type of Project: _New,.,_, Addn __llteration _Repair Type of Project: _Now ^_,Addn Alteration J.-Repair <br /> Fix-turas . Ixtures flxture9 List of F! urea Nx u ixthist of Fixtures tee F � List of FFJxtares <br /> AI•—AIr Handl Units Heat res <br /> P p Toilet Backflow Preventer(Inside Bldg) <br /> For ad Air S stems <br /> U eater Bathtub Urinal <br /> Gas 'iptnq oiler Lavatory(Wash B_asln) Drinking Fountain• <br /> Wet= Heater Refrj eratIon ;Shower Floor Drain <br /> Gas F e'lace Wood Stove Kitchen Sink&Disposal 'Grease Trap <br /> Gas R: go Ducting Dishwasher Roof Drains <br /> Clothes I er Hooku•: •.I/er: Clothes Washer.- Medlcal Oas <br /> RanEe H•.d Water Heater Other: <br /> Exhaust F--�' Sink iService/Bar/Mop/etc.) Other: _ <br /> . SPRIN, - - • • ESSIO M <br /> • •mica!or W: :, ..of Heeds - - - - <br /> A <br /> ACKNOWLEDQEM N7:I have reviewed this application and COMM the information contained herein fa true and correct.Work done pursuant to this permit must comply with <br /> current federal,slate;and local law.The granting of a permit only authorizes approved work and no deviations thorehom.Deviations must first be authorized In writing horn the <br /> Building official befoh being authorized under any circumstance.I am the owner:or I am authorized by the owner Of this properly to perform the wort(for which application Is made, <br /> and I comply with the State Contraotors4 UW10.27 RCW and 200.200A WAC <br /> City of Everett ofncioi Use Only • <br /> ,FAI A .,ki ,i Fr3- 12- PEF <br /> Own' •uthorzel Ag: Signature Data (Revised9/ T ,f: , <br />