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08/03/2017 3:47 PM FAX 4258671555 ALLCLIMATEHEATING a 0002/0002 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER I DEMOLITION <br /> #11.4• --.4 CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8657 i(E)everettepsteverettwa.gov I www.everettwa.gov/permits <br /> Blue or Black Ink Only Please) PROJECT SITE INFORMATION f. <br /> PROJECT SITE ADDRESS: :,. /,. Q3 r, '4 , PROPERTY TAX#: 24`7 "(5,€)- <br /> LEGAL for new construction: Short Platlsubdivislon Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> ��� <br /> OWNER NAME: • <br /> �' :,( er Ue� TENANT NAME(If Commercial): �T' �� <br /> OWNER MAILING ADDRESSSTREET 7) /pp7)r 9- _ V <br /> CIN /..Vt re.J4- STATE //1/4 ZIP 9i4a <br /> OWNER PHONE: L(25- 7 (e(0 r '7-j 'OWNER EMAIL: .--- <br /> CONTRACTOR <br /> -CONTRACTOR NAME; A l (1,(orAn•-;.c. {if'1 c , <br /> CONTRACTOR ADDRESS: STREET ' - NE., ( ? ' ±: /' <br /> o1N C• c4 on STATE (A J4 Zip <br /> CONTRACTOR PHONE: 1.4'7_,5-- (1.r (-- 2j P -3• CONTRACTOR EMAIL: C J C (�,Lt t., i <br /> CONTRACTOR LICENSE#(REQUIRED): . (0 e (Q CITY OF EVERETT BUSINESS LICENSE#(REQU -1 •_r f <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> NCONTACTNAME': L CONTACT PHONE: a.Tj- L4 2,o'/. <br /> 3u p n kis CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION S <br /> Existing Use of Building: Contract Price of ork:$ 6:, (r4 <br /> Proposed Use of Building: Heat Source: a ti Electric ❑• er <br /> Building T pe: ❑SFR-Detac =d 74 R-Attached ['Duplex ❑Multi-Family-# Units: II'tmmercial ❑Industrial <br /> Type of Project; ❑New 'A L..itlon DRemodel ©Repair ❑T.I. DSign ❑Sprinkler ❑Demalition OChange of Use <br /> DESCRIPTION OF WORK: <br /> cot/) pkvin m . 0 (CA C - <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> . MECHANICAL PERMIT APPLICATION • PLUMBING PERMIT'APPLICATION • <br /> Type of Project: Now _ Addn _Alteration _Repair Type of Project: _New _Addn Alteration Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of <br /> Fixtures FixturesFixtures <br /> _ Fixtures List of Fixtures <br /> AIC-Air Handling Units Heat Pump Toilet .. Backflow Preventer(Inside Bldg) <br /> Forced Alr Systems Unit Heater Bathtub Urinal <br /> 1 Gas Piping — Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration _ Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Diains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other. <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINK ER/SUPPRESSION SYSTEM <br /> Che cal or Water I Iwo.of Heads <br /> ACKNOWLEDG MEN :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, .tate, ,nd 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 Officio, •efo -being auth,. Sed• der any circumstance.i am the owner,or f am authorized by the owner of this property to perform the work for which application is made, <br /> and!Comply With a Stale Co clo Law 98.27 RCW and 296.200A WAC. <br /> • City of Everett Official Use Only <br /> ,,• <br /> c/f <br /> � / P7./i.' ERMI _ <br /> oG <br /> Owner/• .fronzed Agent Signature Date (Rent oT# <br /> 3/201 <br />