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Nov 23 2018 09:54AM Washington Ili Heaters 8663757454 p. <br /> PERMIT APPLICATION <br /> BUILDING I MECHANICAL! PLUMBING /.SIGN/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-B857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: Pleases <br /> ft { !PROPERTY TAX#:D1 ff t ��I/V <br /> LEGAL for new construction: Short Platlsubdivision `-'� Lot No. (attach copyof longlegal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:cans` U Caste' fl TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET i.4 f 5 Z c.„SE <br /> ciTr Eve `/7,1/, <br /> STATE ZIP ! Y�0 <br /> OWNER PHONE: 'OWNER EMAIL: L7 <br /> CONTRACTOR NAME 14.4 t ki6?T1GN Q fig--- .rHt47 1$ <br /> CONTRACTOR ADDRESS: STREET flh('5Z Z . <br /> 11 (, •• ,4-v1 56'. - Pc gox 6-926S, <br /> r <br /> din, �.'✓�J t�lr 1 STATE f J ZIP q f i 5g <br /> CONTRACTOR PHONE: 4/26'/243- C/ '7/ CONTRACTOR EMAIL: fj(,I --Wji-HVficr CD6 aid9 itr OW <br /> CONTRACTOR LICENSE#(REQUIRED): w# Lc5&gSri ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED); Os 3 <br /> PRIMARY CONTACT: D OWNER [CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME* CONTACT PHONE: 2 Ig3-(j'7/ <br /> UKC 1 bafir-els CONTACT EMAIL: r i�'f}�tlJft.} t,ice!@ 6474-g,,600,1 <br /> ._ BUILDING PERMIT APPLICATION <br /> Existing Use of Building: e i.( 42. t-h (a Contract Price of Work:$ gj( af _` <br /> Proposed Use of Building: Heat Source: as DElectric DOther _ �� <br /> , <br /> Building Type: ©SFR-Detached ❑SFR-Attached ©Duplex ❑Multi-Family-#of Units: ❑Commercial Dindustriai <br /> Type of Project ONew DAddition ❑Remodel DRepair DT, OSign ❑Sprinkler DDemofitlon DChange of Use <br /> DESCRIPTION OF WORK: <br /> g.,,,,,„-,, ,a)ofre-t_ , <br /> ogi <br /> tudifr'. kale) <br /> ASSOCIATED BUILDING PERMIT# <br /> (if appiicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration Re ai '.� <br /> _ p Type of Project: New Addn _Alteration _Repairf7 <br /> #of #of *of #of � <br /> Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures List of Fixtures <br /> AIC-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> 1 Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove 'Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains - <br /> Clothes Dryer Hookups Other. Clothes Washer <br /> Range Hood Medical Gas <br /> Water Heater Other: - <br /> Exhaust Fan Sink(Service/BariMopfetc.) Other: - <br /> • SPRINKLER 1 SUPPRESSION SYSTEM <br /> 'Number of Heads <br /> ACKNOWLEDGEMENT'I have reviewed this application and confirm the information contained herein Is true and correct, Work done pursuant to this permit must comply with <br /> current federal,state,and local law The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Oficial before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18. 7 RCW and 296 200A WAC. <br /> City ofEverett Ofcial Use <br /> Only <br /> tr� UA— 9 I1Z34c( IPERMn ot, otisi <br /> IwnerlAuthorized Agent Ignature Date <br /> (Revised 5�0/2[)i6) <br />