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12/01/2017 FRI 9: 26 FAX Fast Water Heater Z005/007 <br /> PERMIT APPLICATION <br /> g\41-1) °tgid' <br /> „App_ <br /> , .,.•• ,.......4 BUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-0810 I FAX 425-257-8857 I(E)everettepegevereltwa.gov I www.everettwa.gov/permits <br /> (Mule or Black Ink Only Please) PROJECT SITE INFORMATION . <br /> PROJECT SITE ADDRESS: r 0 A ` i S PROPERTY TAX#:ob 13. GI i 0'1 ►P <br /> LEGAL for new conetructlon: Short Piet/subdivision J.ot Nom_, (attach copy of long lege!desorlptlon) <br /> CONTACT INFORMATION <br /> OWNER NAME: i TENANT NAME(If Commercial):ISD T �a�Gl� � <br /> OWNER MAILING ADDRESS: trraeerD1 - &J',JOD E�. , �(J �.... <br /> onv /v.��j • SYAYE zip 1 <br /> OWNER PHONE: '-' -5 3 Li 14 !OWNER EMAIL: — <br /> CONTRACTOR NAME; fA ST kid( i •,� 1i AT i _ <br /> CONTRACTOR ADDRESS: fdl e . r i D ^ <br /> c� V1 r L.1.- ,tom mwm USP- 2P �� 01.i <br /> CONTRACTOR PHONE: 125- 10. 11� 'CONTRACTOR EMAIL;p iz m 1T5 pi �"U� VU!Q r..(,OVl1 <br /> • CONTRACTOR LICENSE#(RE=QUIRED): V TW N' o CITY OF EVSRETT BUSINESS LICENSE#(REQUIRED) •453 <br /> PRIMARY CONTACT: D OWNER fY.CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: 1 CONTACT PHONE: LI g�13Le <br /> \C,41-11 - CONTACT EMAIL: Qe it/�/1,I- w , `�'p pL(,...1-�', C4:51/11 <br /> v 1 <br /> 1 ""r� <br /> BUILDING PERMIT APPLICATION r}n _ <br /> `e Existing Use of Building: Srg '" Contract Price of Work:$ .1d h <br /> Y" Proposed lice of Bulldlnz bfe, _ Heat Source: Klee DElectrla COOther i <br /> Building Type:( FR-Detached USER-Attached C1Duplex iMultl-Family-#of Units: UCcanrnerciel 0Industrlal _ <br /> Type of Project: DNew DAddition L7Remadel alRepalr DTI. Cisign ClSprinkler CDemolltton DChense of Use <br /> DESCRIPTION OF WORK: <br /> nf) ova t/ Ire \Vice C7fl-S w.M-e'r \11.e a.-\--e r <br /> ASSOCIATED BUILDING PERMIT#(If eppllcabier__ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: __New Addn-_Alteration _Repair 'Type of Project: _„New .,,__Addn __Alteration Alteration -epalr' <br /> #of <br /> Fixtures List'of fixtures ,Fixtures List ofi!4ures Fixtures List of PiFixtures Flxturas '' Lie •f FJMQree <br /> A/C-Air Handling Units Him Pump Backflow a eventer Inside BIdl <br /> Forced Air Systems 'Unit Heater Bathtub Urinal <br /> ` Gars Piping _ • _ Boller Lavatory(Waah'Basln) Drin, g Fountain _ <br /> 1 1 l Water Heater Refrigeration Shower F .or Drain <br /> V Gas Fireplace Wood Stove Kitchen Sink&Disposal _ 'emu*Trap _ _ <br /> Gas Range Duotinp - Dlshwaeher R• Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medlc, . as <br /> -• Range HoadWater Heater Other: <br /> Exhaust Fan .. .- Sink Service/Bar/M•sate. Other <br /> NI <br /> sPkiIN., • •.• - -Ammo IUI <br /> m aurical or W •.of Heads <br /> AOKNOWLEDGEWIT•I have reviewed this op.pik et and confirm the Information contained hereby Is true and correct Work done pursuant to this permit must comply with <br /> cunent federal,stem end local law.The granting of a permit only authorizes approved work end no deviations Tomentum.Deviations must first be authorized In writIng horn the <br /> BUNding Offlolal before being eulhorized under any circumstance,i am die owner,or l am buthorized by the owner of(Me property to perform the work for which application is made, <br /> and I comply with the State Contractors Lew T6.27RCW and 21161.200A WAC. <br /> Cliy of Everett Official Use Only <br /> • r PERMIT , <br /> �►..� 1 — I 11' Z 11CI <br /> own' ,uthar ze+Ag Signature Data -ev sed 9/2 ' a <br />