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01/03/2018 WED 12: 23 FAX Fast Water Heater 009/012 <br /> g7),3g <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING SIGN I SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> _ (P)423-257-8910 I FAX 425-2578887 I(E)everettepsre.everellwa.gov I www.everettwe.gev(permtts • <br /> (Blue or Black kik OnlyPI®as® PROJECT SITE iNFORMATION <br /> PROJECT SITE ADDRESS: I5-tv C -P >P 1 U PROPERTY TAX 0: 60(4"-/-b ."- I I iPOo6T <br /> LEGAL for new construction: Short Plat/subdivision tot No. (atteoh copy of long legal desorlpllon) <br /> CONTACT INFORMATION <br /> • <br /> OWNER NAME: 0 d/k �; L )tr• A TENANT NAMEIf Commercial): --- _ <br /> OWNER MAILING ADDRESS: smear j5D &i 41\1 enq�j/���v ;./V aTAYt VA 211' !621)1/ <br /> OWNER PHONE: a •3g OWNER EMAIL: <br /> CONTRACTOR N - SI— i&j Ai e VA• -AT i� _ <br /> CONTRACTOR ADDRESS; smear Lai N__Cylei c ► , <br /> cL ...12213± 1,1_,—_ -• STATE LY ZIP ' 'V. <br /> CONTRACTOR PHONE: (-'l)S to.31,P CONTRACTOR EMAIL:F1'iz rn tT S p ,sawas- ( & -LI�w c'r, £vM <br /> CONTRACTOR LICENSE t�REpuiRE_D):fAS11K M'alLI3 pj� !CITY OF EVERETT BUSINESS LICENSE#(R•EQUIRED) (453 <br /> PRIMARY CONTACT: CI OWNER (KCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: /� f--41) -- CONTACT PHONE; '-1 r ' L,� 91:)g1-1 <br /> 1CA- CONTACT EMAIL: P ' t44,1t5 i lk)/ 1 <br /> BUILDING PERMIT APPLICATION <br /> ��� <br /> Exiatln! Use of Bulldin,: � WWI Price of Work:.� <br /> Pro•osedUse ofButidtn•: `3 ' Heat Source; 1!ccs ICElectric DOther - <br /> Bullding Type: DSFR-Detached ©SFR-Attached DDupleX CDMuitl-Famlly4 of Units: ©Commercial ©industrial <br /> Type of Project: ©New ClAcidition ❑Remodel kRepair DT.L' ©Sign O9prinkler DDemolitlon OChange of Use <br /> DESCRIPTION OF WORK: <br /> Finn 0v6 / r-eQ\Ace. CA- s w a\-eAr 1n c a,te- <br /> A8SOCIATED BUILDING PERMIT#(if epplicabie): <br /> MECHANICAL PERMIT APPLICATION ._ PLUMBING PERMIT APPLICATION <br /> Typo <br /> _of Project: Now Addn `Alteration _Repair Type of Project: _New _Adds _ ,Alteration _Repair . <br /> fi or Use of Fixtures #of List of Fixtures #or List of Fixtures 44°{ L r Fixtures <br /> Y Flar_turea_ Fixture, Fixtures Fixtaree <br /> u <br /> A/C—Air Handlln! Units Haet Pum• Toilet Backfl Preventer(Inside Bldg) <br /> Forced Alr Systems Unit Heater =- Lib Uri • <br /> I!Gas Piping Boller avatary(WashB_asin) D,nt kIng•Fountain_ <br /> Water Heater _-Refrieration Shower d -door Drain - - <br /> Gas Flre•lace Wood Stove Kitchen Sink 81 Dls*mai Grease tri <br /> Gas Ran!e Ductlne Dishwasher -oof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Me• el Gas I <br /> Range Hood _ - Water Heater Other: •• <br /> Exhaust Fan Sink(Service/Bar/Mo. : .) Other: <br /> SPRINKL AESSI R_SYSTEM <br /> arnica!ori .of Heads ' <br /> ACIWOWLEDQEMgN7:I have reviewed(his application end conNrm The informallon contained herein is(rue end correct.Work done pursuant to this permit must comply with <br /> current federal,8(a(a,end local law.The granting ora permit only authorizes approved work end no deviations(herehhtn.Deviation must first be authorized In wrlfng from the <br /> Building Official Setif being euihonted under tiny clroumstencs.I em the owner,ori em authorized by the owner of offs property to perform the work for which epp/loatron is made, <br /> and i comply with the State Contreolora Law 1e.27 RCW and 29&20OA WAG <br /> City of Everett OMolel Use Only <br /> i* , - •( 3-. 1g PERMIT 0/ <br /> Own: •other ze Ag Signature Date (Revised W232 9e <br />