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12/05/2017 TUE 13: 42 FAX Fastigter Heater 2007/005 <br /> . go 1 i;q_ei <br /> PERMIT APPLICATION <br /> �,�,r BUILDING /MECHANICAL/PLUMBING/SIGN/SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> • (P)42S-257-0010 I FAX 425-2576657 I(E)everetteps@everetiwe,gov l vrww.everettwe.gov/permIts • <br /> (Blue or Black Ink OW Please) PROJECT SITE INFORMATION - <br /> PROJECT SITE ADDRESS: r r I OL�� PR PROPERTY TAX#: OX J F5/Ax d$Cc,lc- <br /> LEGAL for naw construction: Short PlaysubcNtston, Lot No. (attach copy of long legal description) �� r <br /> CONTACT INFORMATION <br /> OWNER NAME: JwJ' 0,0,114Lid 5i-- TENANT NAME�y _(If Commercial): <br /> swear MAILING ADDRESS: sser.y{0'036 HolL y pe. .g✓J <br /> crn .i/�!K`- + . STATE Wit TJp ,q82.6y. <br /> OWNER PHONE: ,/ , 0 r OWNER EMAIL; ---' <br /> CONTRACTOR NAME: fPi ST AI . VI- -A-1-?...g'. <br /> CONTRACTOR ADDRESS: 97aGEr ,' ,, 0 a.....' S p <br /> op; ,'P DIV(T ( VSTATE , Al • zip ' ♦ )' <br /> CONTRACTOR PHONE: ('-'1 5- • (r3 I .�CONTRACTOR EMAIL: ir I I-TS hIJ/04.4 1/leir <br /> . / <br /> CONTRACTOR LICENSE'#1(REQUIRED): "nA)�`�-}otL j 3c, CITY OF EVERETT BUSINESS LICENSE e(REQUIRED)5D45-3 <br /> PRIMARY CONTACT: CJ OWNER (,FCCONTRACTOR 0 OTHER(Please Speoity) __._. __ <br /> CONTACT NAME: CONTACT PHONE: L-1 5 -7L S <br /> \/"'1"--cj ��L. - CONTACT EMAIL: ►M,��S cA,Ci n•-ire,r, WI <br /> BUILDING PERMIT APPLICATION <br /> 14. Exiatin t Use of Bulidin!: 4. Contract Price of Work:$ I� �� _�� <br /> Proposed Use of Building: SiHeat Source: as DElectric ©Other <br /> Building Type:4SFR-Detached CISFR-Attached ❑Duplex °MuItI-Family-#of Units: °Commercial. 171lndustrieI <br /> Type of Project: ❑New °Addition °Remodel agfReealr °T.I. °Skin °y/Inkier t Demolition °Change of Use <br /> DESCRIPTION or WORK <br /> ills D\#C l re.P\ Ce EAS 0C -W \A C at-.. <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> -.. <br /> Type of Project; _Maw_ Addn `Alteration _Repair Type or- _. • New _Adds _Alteration ,.... Repelr <br /> #of /At of FYxturea #°f List of Fixtures #of Mat of f=ixtures #of Ltst of Urea <br /> 1 Fixtures Fixtures .Fixtures Fixtures <br /> A/C=Air Handling Unite Heat Pump diet Backflow Pre ,anter Inside Bide <br /> r Forced Air Systeme Unit Heater Bathtub <br /> aOas Pl.In• Boiler ' Lavatory(Wash Basin) Orinkin. ountalnj <br /> lbaWater Heater Refrleeratlon Shower •. •rain m <br /> mow_ Gas Fireplace , Wood Stove Kitchen Sink&Disposal le = =Trap _ <br /> Gee RangyDudting Dishwasher - Roof D s - - <br /> Clothes Dryer Hookups , Other: Clothes Washer - Medical(3•r: <br /> Retie Hood Vater Heater Other: <br /> Exhaust Fen , •.T' ,) Other: <br /> . SPRIN. E8Sl L S IUI <br /> T� • <br /> ' • emical ar W_,- • ••.of Heads <br /> ACKNOWLEDGEMFjNT:I have ravlawed this application and confirm the Won-nation aorta/nod herein le true end conaci Work done pursuent to this permit must comply with <br /> current federet Mate,end local law.The granting of a petrol!city authorizes approved work and no deviations thefefiom•Deviations must first be authorized In writing from the <br /> Building Oficial hefeiv being eulhorized under any circumstance.I em the owner,orf em authorized by the owner of this property to pertbrm the work for which application is made, <br /> end I comply with the State Contractors Low 13,27 RCW and 29&L200A WAC- <br /> City of LaveAsft Ot/Toial Use Only <br /> di 1 ,,P i' (9-5- i ?- Prrt q- 2 --O <br /> Own- •ether ze. Ag: Signature Date (Revised 0123/2016 <br />