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09/28/2017 THU 9: 39 FAX Feat water Heater 0002/005 /4P. PERMIT APPLICATION BUILDING/MECHANICAL 1 PLUMBING I SIGN/SPRINKLER I DEMOLITION 145- CITY OF EVERETT PERMIT SERVICES - 3200 cEOAR STREET,EVERETT,WA 98201 (P)423-257-8810 I FAX 425-257-8057 I(E)eve retleps©evereUwa.gov 1 www.overetiwe.gov/penults - Blue or Black Ink OW Phase PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 10 i 18 ! D S PROPERTY TAX#: D0 ' i' ø6 0. , LEGAL for new construction: Short Piet/subdivisiorl - _ Lot Nom-,,, (attach copy of Ions legal description) CONTACT INFORMATION OWNER NAME: Y C/Jfl L GI A TENANT NAME(If Commercial): OWNER MAILING ADDRESS: nem a l 1 g etg pe-- S City V V STATE til / 211 OWNER PHONE: ! c ,, q 3 OWNER EMAIL: .------- CONTRACTOR NAME: rA ST VI Al VAS-41—F) CONTRACTOR ADDRESS: 8TREET ‘a 15. N QV3 eZ-- cK4AN S C. l Dtp V .1cm '�J 11-1'a � _ - - STAB .,,k_i 21P 61 ' C� ' CONTRACTOR PHONE: 4-0 5 / /l ► CONTRACTOR EMAIL: f P VYl ITS f .\-LUk \it u-te/r. 1 CONTRACTOR LICENSE S' #(REQUIRED): r`IA)Wf 1 -1 D sc.. crry OF EVERETT BUSINESS LICENSE#(REQUIRED)5 D L153 PRIMARY CONTACT: LI OWNER (CONTRACTOR Q OTHER(Please Specify) CONTACT NAME; CONTACT PHONE: L1 P5 r -3(..P ''3-lp KA- 1 "Y�1 1-- CONTACT EMAIL: 2.Q�wi,� L" 5.��r ,1.C,op n-�-�. C'Ov1 BUILDING PERMIT APPLICATION n �` 4"' ILExisting Use of Building: 5 f 4` " _ Contract Price of Work:$ 1607( .._. _� __--_ _ - •,_ _ C' Proposed Use of Building: S 0,._ Heat Source: Mae DElectric DOther Bulidln_g Tyle: R-Detached IDSFR Attached ©Duplex DMuIA-Family-#of Units; DCommerclal Dindustrial Type of Project: DNew DAddltlon DRemodel I Repair DTI DSlgn ©Sprinkler DDemolltion DChange of Use DESCRIPTION OF WORK: f .VY\ 0\ie, / re4)\ACe /(4.,S W 0*elr \A e oc-t- ASSOCIATED BUILDING PERMIT#(If applicabl): - M!CNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration Repair Type of Project:_New _Addn _Alteration ---Repair , #of List of Fixtures #of Us•• - *or Llai of P►xfuras Fixtures - Fixtures Fixtures HandlInt Units Heat Pump Toilet Backflow Preventer aide Bid. , Forced Air S steUnit Heater Bathtu Urinal .._. c... Boiler r Lava •u = Drinkine Foun • n IHMWater Heater• Refr�eration Shaw r Floor Dral Gas Fireplace Wood Stove Kitch i n Sink.61.Disposal Grease --ap Gee Rang - rutting Dish :cher Ro• •rains _ Clothes Dyer Hookups ether: Cloth=:Washer 1 P dtcal Gas Range Hood - r Water ester, • er: Exhaust Fan .. Sink Se ice/Bar/Mo./etc, Oth ' - • g• -I : - - -4SSIO_KsAtEsTIlM , .----' e arnica!or. = _ ' 11111111 fes.of =_•- ACKNOINLEDGEM NT I have reviewed this eppllcallan and confirm the lnfefneflon confalned herein is true and awed Work done pursuant to this penult must comply with current federal,stale,end local taw.The granting of a permit only authorizes approved work end no deviations therefrom.Deviations must fist be authorized In writing hem the eufding Official before being authorized under any circumstance.I em the owner,or!am authorized by the owner of(No property to perform the work for which eppiketlon is made, and l comae with the Slate Contractors Law 16.27 RCW end 29ez00a WAG. CI, orEverett oeiaief Use Only 01-cg.-- 1 _ _ .4 -0' Own uthor ze At Signature Date (Revised 9/23/2098)