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Nov 28 2017 10:33AM Washington Wa=—Heaters 8663757454 peg 1 <br /> j ►=' BUILDING /MECHANICAL PLUMBING i'SiGN I SPRINKLER/DEMOLITION <br /> 11PCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 i FAX 425-257-8857 1(E)everettepseeverettwa.gov i www.everettwa.govfpermits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: -7. ' Ar u C eV r VC,. <br /> LEGAL for new construction: Short Plat/subdivisionPROPERTY TAX#: (:201-/�� �����1��� <br /> Lot No, (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: k)77 A 7672. <br /> TENANT NAME(1!Commercial): — <br /> OWNER MAILING ADDRESS: STREET <br /> 72," (,4 c K-e v aPe--' <br /> CITY P_,414 I rf{J <br /> STATE ZIP Q , <br /> OWNER PHONE; <br /> L ZJ-Z�.0 ` J OWNER EMAIL.: I <br /> CONTRACTOR NAME: UM-94i mano <br /> CONTRACTOR ADDRESS: STREET I-115 Z l i( t <br /> • Al <br /> OX 92a • .arni► <br /> clry tii.f-661 <br /> CONTRACTOR PHONE: 4/26- , ► _ STATE Of/4- ZIP111 <br /> • CONTRACTOR EMAIL: r b�•61 • <br /> CONTRACTOR LICENSE#(REQUIRED): 6(Ji4— d� j / 1 Y'C <br /> a CITY OFF EVERETT B BUSINESNES S LICENSE#(REQUIREDRED IMMUI <br /> PRIMARY CONTACT: ❑OWNER r CONTRACTOR 0 OTHER(Please Specify) <br /> IMIE <br /> 'Co ME CONTACT PHONE: 2 �r3-Ca 7 'jant-e fS CONTACT EMAIL: 1,44-b(49-� , 6� L.( �✓ <br /> BUILDING PERMIT APPLICATION 41111111111 <br /> Existin• Use of Building: !IF ` I► <br /> Proposed Use B Alin.: <br /> F <br /> Contract Price of Wor : TM_ � <br /> Heat Source: ❑Gas L* MI Other <br /> Building TA.• : �� -Detached ❑SFR.Attached i]Du+lex ❑Multi-Fsmil #of Units: <br /> T oect: I ew DAddltion ❑Remodel ❑Repair ❑T.i. ❑Sign ❑S•rinkler ■'eemolitil ❑Cftan!eoaln <br /> DESCRIPTIONd <br /> OF WORK: <br /> l► � <br /> quier <br /> bit.Q i.. �-- keip <br /> ICLeX 1 -e tech-Lc) 1u i/ k J-(., <br /> ASSOCIATED SIJILD1NG PERMIT# if al.licable: <br /> MECHANICAL PERMIT APPLICATION <br /> Type of Project: New..� AddnAlteration Repair PLUMBING HERMIT APPLICATION <br /> #of #of Type of Project: New Addn Alteration <br /> Fixtures <br /> List of Fixtures a f Repair <br /> Fixtures List of Fixtures List of FFXtures #of <br /> MI A/C-Air Handiin. Units Fixtures List of Fixtures <br /> Fixtures <br /> Forced Air S stems BTatlet Backflow Preventer inside Bldg) <br /> am Gas Pl.ing Bathtub r <br /> Sailer EIRC l Lavato Wash Basin <br /> 11.11111 Gas Fireplace _Refri'eration Shower Float Drain Ft}untain <br /> MIMI Wood Stove Kitchen Sink&Disposal Floor <br /> min Clothes 0 •r Hookupsmmunumm <br /> Other:MIN ' Dishwasher ` <br /> Range111.111 Hood Clothes Washer _MIN Roof Drains <br /> �alE Medical Gas <br /> IIIIIIIIIENEININNINNIIIIIIIIUIIIIIIIINEN 1111111111,._1111111.....11111111111m........111111111.11....... <br /> Other: <br /> 111111.1_ 11111.11111m.m. MINE Sink SaMce/Bar/MO•/etc, Other: <br /> SPRINKLER i SUPPRESSION SYSTEM <br /> IIIIIIMMIIIIMINIIIIM <br /> Number o Heads <br /> ACKNOWLEDGEMENT.' reviewed this application and confirm the information contained herein Is true and correct.Work d��� <br /> currant federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom,Deviations must that be authorized b <br /> Building Official before being authorized under any circumstance,1 pursuant to this permit must torr <br /> ar' • With the Stale Contractors Law 18.27 W and 29020 Wq or I am authorized 6y the owner of this �y h <br /> property to perform me wr/fl»q from the <br /> work for which apptlon is <br /> made, <br /> • <br /> - <br /> arr� , tag <br /> a�u� • <br /> f'` PE 1 # <br /> City of Everett Official Use Only <br /> OA Ow'pith zed Agent Signature <br /> Date aG1 <br /> (Revised S/20/2018) <br />