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11/21/2017 TUE 11: 45 FAX Fast water Heater 0008/008 <br /> A PERMIT APPLICATION <br /> JTO5"1I <br /> � ...... BUILDING I MECHANICAL I PLUMBING I SIGN/SPRINKLER/ DEMOLITION <br /> ../ CITY OP EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 08201 <br /> (P)425-25748810 I FAX 425-287-8867 I(E)averetteps(glaveretlwa.gov I www.everattwa.gov/permits • <br /> (Blue or Bleck Ink OnlyPlease) PROJECT BITE INFORMATION "' Q 2 ) <br /> PROJECT SITE ADDRESS: IPI/3 (o7Zf7 PL, 5e-- PROPERTY T�+x#: D�,g.J0001-iip&--�6 <br /> LEGAL for now oonstruotlon: Short PlaI/eubdivIelon ___Lot No._ , (attach copy of long legal description) i� .r <br /> CONTACT INFORMATION <br /> OWNER NAME: ii Iii. <br /> OWNER MAILING ADDRESS: STREET j # <br /> crtv . ,' t I am <br /> sraTz i / zip. ° i 1 i! ' <br /> OWNER PHONE: , 5 2,0 I I OWNER EMAIL; ------ <br /> CONTRACTOR NAME: fit SI- i t 11A'T" :� <br /> CONTRAGTOR'ADDRESS: -arlteeT \Y3-V5- N Neu_ ,f) m s <br /> cnY 2 V —L-,, 5TA7E 1 ,;I- BP 1411111111 <br /> ,, <br /> CONTRACTOR PHONE: -- 5 tO� J TO 4 CONTRACTOR EMAIL:P- W\�•T S 66 / A-l>Jotkcx , 'i(vhf . <br /> CONTRACTOR LICENSE#(REQUJREb): S�1J�)S�rl�t',�S� 'CITY OF EVERETT BUSINESS LICENSE#(REDUIREO) a"153 <br /> PRIMARY CONTACT: J OWNER - ( CONTRACTOR C�OTHER(Please Specify) _ <br /> CONTACT NAME: CONTACT PHONE: Li ji ' Li <br /> {, `S�1 �. '/CONTACT EMAIL: P' vfS ' i A ! <br /> Eli 1t l-ire,r, CAW1/) <br /> BUILDING PERMIT APPLICATION <br /> ExletinQUse of Building: 4. ' " Contract Price of Work:$ WO. <br /> Proposed Use of Building: S ° Heat Source: Cilhas DElectric ©Other <br /> BuildIng Type: I:1SFR-Detached u04 <br /> FR Attached EDupiex DMultl-Family-#of Units: - LI Commercial I:Industrial <br /> .e of Pro ect: ❑New CDAddition ©Remodel {A Re•sir 1:1T.I.- 1381.n DS.rinkler CIDemolltlon DChen!s of Use <br /> DESCRIPTION OP WORK: <br /> jinn o , / \ &ce, C,f-Sw ex-\-- 1n . <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> pMCHANICAAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project; _New_ Addn _ ,Altaratlan _Repair Type of Projoot: __Now Addn - Alteration _Rape r , <br /> #of LW of Fixtures #of List of Fixtures #of — — #of list of Fi gyres <br /> Fixtures FtkfurasFixtures Fixture_ <br /> NC-•Alr Handling Unite Heat Puny diet Backflow Proven=r(Inside Bldg) <br /> Forced Air Systema Unit Heater Bathttib Urinal <br /> CS) Gas Piping Boller- Lavato Wash`Basin a rtnkin, Po, =1n <br /> Water Heater Refrigeration Shower ..r Ora <br /> Gas Flreelace Wood Stove Kitchen Sink&Die•osal Greek"-ra• <br /> Oae Renpe - -- - -Ducting Dishwasher Roo 1"a r=•_ s - <br /> . _ Clothes Dryer Hookups Other: Clothes Washer i-dice!6= <br /> Range Hood - Water Heater ' --- Other: ' <br /> Exhaust Fan Sink Service/Bar/Mo. etc. - Other: <br /> SPa�N s i�SSVO SVST M - , <br /> Yert or W ,of Heads <br /> ACKNOWLEDGEM;,N::I neve reviewed this applloetion end confirm the information contained herein Is(rue and correct,Work done pursuant to(his permit must comply with <br /> current federal state,end local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must lirst be eutlorized in writing from the <br /> Building Official belbIS being authorized under any circumstance I am the owner, or lam authorized by the owner of this property to perform the work For which application is made, <br /> and I oompiy wih the Slate Contractors Lew 18.27 RCW and 2942OQA WAG. <br /> City ofEvertlt Official Use Only <br /> VA) PERMIIA! )1/4T'# <br /> Own? •uthor zap Ag Signature Date (Revised 64 /20f8) <br />