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09/18/2017 MON 15: 43 FAX Fag' ter Heater 0006/009 <br /> 10 5 (3()s <br /> PERMIT.APPLICATION <br /> a BUILDING I MECHANICAL/PLUMBING I SIGN I SPRINKLER 1 DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P).425-257.8810 I FAX 425-257-8857 I(E)everetteps@everehwa.gov I www.everettwa.gov/permits <br /> Blue or Black Ink Onl Please PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS_ ' /95 opt i IQ)7e,,e. I ' 'E PROPERTY TAX 0: 6.043 I e 33301300 y <br /> LEGAL for new construction: Short Plet/subdimslon Lot No. _ .(attach copy of tang legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: / IMP(7)1/ I I P_ TENANT NAME(If Commercial); _ <br /> OWNER MAILING ADDRESS: STREET tAP • ' I N I Elg3 U <br /> crry V / '.AM STATE IPA xlr' "I 1 <br /> OWNER PHONE: "I?S -1--1 ' I D` —I OWNER EMAIL: - IPA <br /> CONTRACTOR NAME; f ST VI Al S• VASA.Ttriig. _ - <br /> CONTRACTOR ADDRESS: STREET \(1'►�"15 N I CA — ,Q \.{ S 4 i <br /> CITY VD V LA.-- ewe Liu A- ZIP 1 ' t3 D \ _ . <br /> CONTRACTOR PHONE: L-05- , , g• . CONTRACTOR.EMAIL: ''V e Il l fl • -1'UJ& IN Jo . / <br /> CONTRACTOR LICENSE fi(REQUPRED):fi�S�ww[ 101 9 g$� CITY OF EVERETT BUSINESS LICENSE 40(REQUIRED) ) 155 <br /> PRIMARY CONTACT: D OWNER (CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: V �i CONTACT PHONE: Li 05 / , I• b'\( - 1�Y t v� CONTACT EMAIL: y1/1.1-1r5 ' -Ula fk I/LQDI'.er . WV) <br /> P - <br /> BUILDING PERMIT APPLICATION _ <br /> ExlStlt ysa of Building: F P - Contract Price of Work:$ L <br /> Proposed Use of Building:__ 5V1;) Hest Source: 42Zglas DEiectric DOther <br /> Building Type: tgSFR-Detached DSFR Attached ❑Duplex OMultl-Family0 of Units: CDCommerclal _ Dlndustrial . <br /> Type of Project: CINew ClAddition JRemodel CKRepair DTA,' Sign OSprrnkier DDemoiltlon I IChange of Use <br /> DESCRIPTION OF WORK; <br /> 0U' t/ re,p\Ace GA-3 w°LA-elr \Aca,�- - <br /> ASSOCIATED BUILDING PERMIT 0 if a••Ilcable: <br /> - . .. <br /> MECI4ANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn ___Alteration .Repair Type of Project: _New --Addn _AIteratlon _,Repalr <br /> Fixtures List of Fixtures FixturesVat of Fixtures Fb tures L -- - .`uUM 1 Ixturas List of Fixtu ,• <br /> NC—Air Handling_Units Heal Pump <br /> tor <br /> : Backflow Prove • (Inside Bldg) <br /> Forced Air Systems Unit Heater 13 Urinal <br /> ` 0Gas Piping Boller :.vatory(Wash Basin). Drinking ..untein <br /> Water Heater Refrigeration V _ hower Floor n"=in <br /> Gas Fireplace Wood Stove Itchen Sink&Disposal 0-=ae Tae - - <br /> Gee Range_ Ducting Dishwasher -oof Drains <br /> Clothes Dryer Hookups _ Other: Clothes Washer. . e_dioal Gas <br /> __ Rat --a Hood - -Water Heater O' =r: <br /> Exhaust Fan _ .ink(ServIce/Bar/Mop/e Othe <br /> SPRIN..__-:ani - - :143310 • .M <br /> f ernical or . • , •.of Heads <br /> ACKNOWLEDGEWIT-I have reviewed ih/a application end connmi the Information contained herein Is true and correct Work done pursuant to this permit must comply with <br /> current(ocfera(slate,and loco/law.The granting of permit only authorizes epp+aved work and no deviations therefrom.Deviations must Asst be authorised in writing from the <br /> $ulding Of/lcla/befcre being authorized under any circumstance.I em the owner,ori am authorized by the owner of this property to perform the work far which applloation is made, <br /> end I compry with the Stale Contractors Low 10.27 ROW and 296200A WAG. <br /> Oily of Everett Official Ilse Only <br /> `f 4/ Q ))L S' 181 PERMI I�®ri `®M .. <br /> own- uthor So Ag Signature Date Revised 9/23,2016 <br /> t ) <br />