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01/03/2018 WED 12: 23 FAX Fes-Ater Heater L0008/012 <br /> gi)57-9 .- <br /> PERMIT APPLICATION 611 <br /> /Zjr BUILDING /MECHANICAL I PLUMBING/ SIGN/SPRINKLER I DEMOLITION 5 X57- <br /> CITY OF EVERETT PERMIT SERVICES ��, <br /> ��•L" 9200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-267.8810 I FAX 425-257-8867 I(E)everetteps(z!everellwa.gov 1 www.everettwa.gov/permits • <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION '.'9'•, <br /> PROJECT SITE ADDRESS: :.) (O` I (A) f4IC?H1,/ Jp 1 PROPERTYTAX#: 00(- 1 0601A) ;910 F <br /> rir <br /> LEGAL.for new conetructIon; Short Plet/eubdlvieton_ -- Lot No, (atteoh copy of long legal description) ki <br /> CONTACT INFORMATION _ _ _ <br /> OWNER NAME: cf,A2-02F pl.,S f TENANT NAME Of Commercial): <br /> OWNER MAILINGADt7RESS; erneer 501 (,,) HICK FULA-N•P KD <br /> criv 5v&tee . 6TATE �4J 41, Iry 3 <br /> OWNER PHONE:• 8.S 5°/ g(351, OWNER EMAIL; <br /> CONTRACTOR NAME: fA SiI ii A'` e, R A"T-' /g, }�, <br /> CONTRACTOR ADDRESS: sTREET \V�'�1.5 t'- P Yom}' %F <br /> S r <br /> 1 sm. }V �� am, ,r r *()t1 <br /> CONTRACTOR PHONE: 12 tQj�"�,H <br /> CONTRACTOR EMAIL: i.w 117414- �wtk1/Jck-e'', (,CVIij <br /> CONTRACTOR LICENSE#(REQUIRED):f s�WW T 1 $3G CITY o f EVERETT BUSINESS LICENSE#(REQUIRED) L153 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR D OTHER(Please Specify) <br /> CONTACT NAME: �/ /� CONTACT PHONE: L.i e 3 L <br /> {tete \- 1 V CONTACT EMAIL: 0' kM,WS , /&\ A.) • ►/ • `I(V1,1 <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: 5-r-(2 ......1,10____ ___,Contract PrIce of Work;$ <br /> Pro!used Use of Buildin 41- l Heat Source: Picas ©Electric Dother <br /> BuildingType:i'_ FR-Detached ❑SFR-Attached °Duplex DMuit!-Family-#of Units:_. - ©Commercial Dlndtietrlal <br /> Type of Project: ;New ©Additton DRentodel efitiReyalr CIT.i, ❑SIgn CIS prinkler t7DemolItlon OChange of Use <br /> DESCRIPTION OF WORK: <br /> fThe,\An 0\IC / Yek10.4kCe, CI A-S LA)OLk-e))( \AC cA,-- <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _ Alteration _Repair Type of Project; _New ,_Addn _AItoradonRepair <br /> tea List of Fixtures F�:tut as Liat of Fixtures Fixtures /Jet of F(xturea FrMuree Lis of Fixtures <br /> NO—Air Handling Units Heat Pump , Toilet Backflow v venter1nsi Bldg) <br /> Forced Air Systems , .. Unit Heater Bathtub Urinal <br /> ` Gas Piping Boller Lav- r T_- -._-In) Drink g Fountain _ <br /> Allk Water Heater Refrigeration ower Fl Drain - - <br /> Gas Fireplace Wood Stove Itchen Sink&Disposal tease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> ' ' •Clothe a Dryer Hookups Other: Clothes Washer . Medical Gee <br /> Ren:a Hood I,ater Healer « ii er: <br /> Exhaust Fan . y • Si Service/Bar/Mo. : c.) Other: <br /> • . <br /> SPRINN I /a. ESSlO eSTEM _ <br /> t arnica!or Vit.' .of Heads u <br /> ACKNOWLEDGBMf J7 thaw reviewed this application and confirm the Info:mellon contained hereat Is live and correct Work done pursuant to this permit must comply with <br /> current faders!,stele,end local law ma granting of a permit only authorizes approved work and no de vlellons therefrom Deviations moat first be authorized In writing(torn the <br /> Building Official before being authorized under any clrcumatarice.I em the owner,or!em euthorixad by the owner of this properly to perform the work far which applicaflon IS made, <br /> and I comply with the State Contractors Law 18.27 ROW and 206.200A WAG <br /> g City of Everett Official Use Only <br /> ..!`� ► 1 ..�►... -- 3 - i _ <br /> PE # <br /> Own, •other ze.Ag.- Signature Dale (Ravier d 3/201 <br />