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PERMIT APPLICATION <br /> 'T BUILDING/ MECHANICAL/PLUMBING I SIGN/SPRINKLER/DEMOLITION <br /> /-°1 --IP A <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE 1 I,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov l www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:6811 Commercial Ave PROPERTY TAX#: <br /> LEGAL for new construction: Short Platisubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: James Glary TENANT NAME(If Commercial): <br /> OWNER MAIUNG ADDRESS: STREET 6811 Commercial AVE <br /> cnY Everett STATE WA z a 98203 <br /> OWNER PHONE: 720-280-9766 OWNER EMAIL: <br /> CONTRACTOR NAME: Tim Hamblen <br /> CONTRACTOR ADDRESS: sTReer 7409 68th AVE NE <br /> cm Marysville Stan WA ZIP 98270 <br /> CONTRACTOR PHONE: 425-501-0123 CONTRACTOR EMAIL: hamblen.sons@gmail.com <br /> CONTRACTOR LICENSE#(REQUIRED): HAMBLESH922DE CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER , CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> Remove existing NG water heater& replace wi CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$,mWa .. <br /> Proposed Use of Building: Heat Source: ©Gas DElectric ©Othermm <br /> Bulldin• Ti.e3: DSFR-Detached OSFR-Attached DDu.lex ©Multi-Famil -#of Units: OCommercial ©Industrial <br /> ;Type of Protect °New °Addition ❑Remodel Q tepair DT.I. DSign ©Sprinkler ©Demolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> ge44Cifit.. 7/4444, yv.ft• tP/ace wj 4c5. 4as.2E / ' © gas /ir 7e-, fz? `44•. <br /> ASSOCIATED BUILDING PERMIT# if a..licable: Remove exi <br /> MECHANICAL PERMIT APPLICATION', ' PLUMBING PERMIT APPLICATION <br /> ; <br /> Type of Project: New Addn _Alteration 'Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures ' #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> ! NC—Air Handling Units Heat Pump Toilet Backflow Preventer(inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> 1 Gas Piping Boiler lavatory(Wash Basin) Drinking Fountain <br /> 1 Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.). Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Chemical or Water I No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is 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 therefrom.Deviations must first be authorized in wnting from the <br /> Building Official before being authorized under any circumstance.I am the owner,ort am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 16.27 RCW and 295.200A WAG. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Timothy Hamblen ‘• /9• //3 <br /> Owner/Authorized Agent Signature Date (Revised 9/23!2016) <br />