Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
01/03/201$ WED 12: 22 FAX Fast Water Heater 1-&006/012 <br /> PERMIT APPLICATION • <br /> er---4'-N,7- BUILDING i MECHANICAL i PLUMBING I SIGN I SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 08201 <br /> (P)429-257-8:10 1 FAX 425-257-8857 I(E)everettepe®everettwa.gov I wvrw.everettwe-gov/permits <br /> Blum ar Black Ink Onl�r Please) PROJECT sire INPORMATION <br /> PROJECT SITE ADDRESS: 5 • ' At j PROPERTY TAX*: 11 igrOM'+ 0 <br /> LEGAL far new construction: Slott Plat/subdivision Lot No, (attach copy of long legal description) • <br /> CONTACT INFORMATION <br /> OWNER NAME: ' 'Ai At TENANT NAME_(If Com_mercial): <br /> OWNER MAILING ADDRESS: srnaeT '3 t 1 l'y ICE All _ - • <br /> CnY .� '� Brae V.,)1)( la, 3 <br /> OWNER PNONE: OWNE El <br /> ' <br /> • <br /> CONTRACTOR NAME: 'fit' ST l n T <br /> CONTRACTOR ADDRESS; slam 1 ' .. 0 _may , <br /> MY ' V ThL. STATE , ZIP , tg.0 ` <br /> CONTRACTOR PHONE: (-12 S lj l,p f CONTRACTOR EMAIL:Pyr e VY IT S p-9),S3ruJOe4\AD ke". (,61M <br /> CONTRACTOR LICENSE Iti(REQUIRED):q-S->;- ,wOC71 8 5e, ,CITY OF EVERETT BUSENE58 LICENSE#(REQUIRED)50 45-3 <br /> PRIMARY CONTACT: G OWNER (CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: �/ V 'CONTACT PHONE: r '�{ c <br /> ►(-Y� 1(.- `Cf � !.�'Wl <br /> - CONTACT EMAIL: -ft ' %' i'Ujl 1/4'er. i,) <br /> BUILDING PERMIT APPLICATION _ <br /> 14. Existing Use of Building: Contract Prive of Work:$ lied <br /> Pro•oaedUse ofBulldi e: ft. i <br /> R Heat Sources as ❑r=leetrlc ©Other <br /> Qultdin• •e: l', FR-Detached ©SFR Attached ODu•lax OMulti-Famll -#of Units' OCommerclat ©industrial ' <br /> Type of Project: ONew CIAdditlon URemodel IA Repair DT 1,'_OSign ❑Sprinkler ❑Demolitlon UChange of Use <br /> DESCRIPTION OF WORK: ` <br /> jinn D\i6 / kreQ\A.0 �/C A-3 w tx-k--elr C a,-Ic- S <br /> ASSOCIATED BUILDING PERMIT# if e••Ilcebie: <br /> 1NIECHANiCAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Proleot; ___New Addn _Alteration Repair Type of Project! ._New �jtddn _Alteration _Repair <br /> Fixtures List of Fixtures Amu List of Fixtures Fixtures List of Fixtures Fixtures List of fixtures <br /> A/C-Air Handling Unite Heat Pump Toilet Backflow Preventer, aide Bld• <br /> Forced Air Systems Unit Heater Bit Lib Urinal <br /> ` Gas PI In Boiler - vatory(Wash'Basin) 'OrinkIn�F•. In <br /> Water Heater Refrigeration _ ':hower Floor.'= n <br /> Gas Fireplace Wood Stove tchen Sink&Die•coal ` ae Tra• <br /> __ Om Range Ducting a ehwasher 4• f Draine <br /> Clothes D "Ig--:12.12.2-1 s Other: CI•_hes Washer Med Gas <br /> Range Hood We Heater Other: <br /> Exhaust Fan Sink(S� . . . •p/etc.) Other: <br /> SPRIN,„I�.LEIV-BURE1 EeSIO TOM <br /> 4Amlcal .of Heade _ <br /> or W <br /> ACKNO 4tEDCEM1 NT.•1 have reviewed this application end confirm the informelion contained herein is true end correct.Work done pursuant to this permit quiet comply with <br /> current federal.stele,end focal law.The arantIne of a permit only authorizes approved worn end no deviations therefrom.deviations must first be Withered In writing ham the <br /> Sallding Official before being authorized under any circumstance.i em the owner,or I em authorized by the owner of this properly to perform the worn for which application is made, <br /> end I comply with the State Contractors Law 10.27 ROW end 208.200A WAC. <br /> City of Emelt ORA/Use Only <br /> I.-- 3 - g P`\iso -O (. <br /> own uthor xe9 <br /> At <br /> Signature Date (Revised&12$/2016) <br />