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05/01/2018 TUE 7: 01 FAX 429 415 6867 Fast Water Heater UQQ2/005 <br /> gl97)i� <br /> PERMIT APPLICATION <br /> "W. <br /> BUILDING/MECHANICAL/PLUMBING I SIGN 1 SPRINKLER/DEMOLITION <br /> f CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everettops®everettwagov I www.everettwe.govIpermlta <br /> (Blue air Slack Ink Only Please) PROJECT SITE INFORMATIONr/ <br /> 'PROJECT SITE ADDRESS: tT 4 1 c19 11"�I1 S� PROPERTY TAX it:, I 1 w <br /> / y/ A 110 , 0 b y <br /> LEGAL for new construction: Short Plat/eubdlvlalon -Lot No. (attach copy ol1ong legal description) <br /> �h �1 c \ CONTACT INFORMATION <br /> OWNER NAME:D U(�,v S `ft, VV I w v..L.,' TENANT NAME(1f Commercial); <br /> OWNER MAILING ADDRESS: smear ►��� �;�1\ I SW <br /> ��.. <br /> CV MP= STATE ZIP , i C/✓ <br /> OWNER PHONE: ,5 alpilL11111.11 OWNER EMAIL: <br /> deesiele <br /> CONTRACTOR NAME; 'f ST in Al- --4'-A-1---' /� <br /> CONTRACTOR ADDRESS: STREET \�-15 N I .1 S p <br /> y/�� 1 <br /> CITY I; D L- ( ,( <br /> STATE A' ZIP q l] D ` <br /> CONTRACTOR PHONE; -{'2 5 3\p9--0 Skil CONTRACTOR EMAIL:p'i2 1/I1 QT S e6--csA-u dAeAdk sti- . [PI/ <br /> CONTRACTOR LICENSE#(REQUIRED):-M-s ,t)vic\LI'3 BG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)57)115-3 <br /> PRIMARY CONTACT: ❑ OWNER L CONTRACTOR ID OTHER(Please Specify) - <br /> CONTACT NAME: �/ !1 _ CONTACT PHONE: LA a'5- /('� c,,_ go gl,/ <br /> C#� U-e- CONTACT EMAIL: VVL- •S P T f 6 b k . Trow) <br /> EUILDINO PERMIT APPLICATION _ <br /> Exiattn Use of t3ulldin a Coritraaf pries of Work:S. <br /> �� <br /> Proposed Use of Building; S Heat Source: *as. ❑Eiectric ©Other <br /> Bulldin�Typo: I�SFR-I etaaohed 0351 R-Attache. I�Dupfex l�Multi Family#of Untts: ❑Commercial Cllndustrial <br /> Type of Protect: ONew ©Addition ❑Remodel *Repoli' DT.I. C.7SIgn EISjrinkler i DemolltIon OChenge of Use <br /> - <br /> DESCRIPTION OF WORK: <br /> f?Y\(\ D\IC / vre,pAze, Gi)--s <br /> I/0 OCA---eAr VA.C 0‘.t' <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project; New_ Addn AlteratIon _Repair Type of Project: New _Addn _Alteration Repelr <br /> Flxturas- LWof Fixtures Fixfurea List of Fixtures Fixtures Li of of Fixture& FixturesList of Fl ea <br /> AIC-Air Handling Units Heat Pump allot Eackflow Prove i e r,(Inslde Bldg) <br /> Forced Air Systems Unit Heater _ Bathtub Urinal i <br /> 'Gee PI In Boller Lavatory(Wash Basin) Drinking F' nteln <br /> Water Heater Retrlgeretton shower _ Floor It -.1n <br /> Goa Fireplace Wood Stove Kitchen Sink&Disposal _ Gr= :e Trap <br /> Gas Rne <br /> ae _ -- Ducting Dishwasher ,;v.of Drains - <br /> Clothes Dryer Hookups Other: Clothes Washer Me- el Gas <br /> Range Hood Water Heater Other: - .. <br /> Exhaust Fan in1LServlce/Bar/Mo Other: <br /> SPRIN, _ - - .-ISSIO _M <br /> - <br /> t( ernlcal or W. . • Ola.of Heade -: - <br /> ACKNOWLEDOEWN:l have reviewed this application and confirm the Information contained herein is true end 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 end no deviations therefrom.Deviations must first be authorized In writing from the <br /> Building Official Deters being au:hotted under any circumstance.I am the owner,or!em authorized by the owner of this property to perform the work forwhloh application is made, <br /> end!comply with the State Contraotore Lew 16127 RCW and 290.200A W/IO <br /> Q' City of Bveretf Official Use only <br /> '/ .�j ..�� /� JI -I l� PER <br /> irT/fi\ ` OS 2— <br /> Own u(hor l e Ag Signature Date (Revised 0/23/2015) <br />