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12/01/2017 FRI 9: 27 FAx Fast water Heater ldj006/007 <br /> E M11T PLICATION 3610'15 <br /> P R AIS <br /> ie ' <br /> '- BUILDING/MECHANICAL I PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 95201 <br /> _ (P)4125-257-8810 I FAX 425-257-5857 I(E)everettep4everettwe.gov I www.everettwa.gev/perrnits• <br /> Blue or Black Ink Oni Pleatso PROJECT$IT$INFORMATION : <br /> PROJECT SITE ADDRESS: �jTaw r (, PROPERTY TAX#: r ,i ,��,�I ��0 0 <br /> LEGAL for new construction: Snort Plat/subdlvtelon _ Lot No.__ (attach copy of long legal descripllon) i <br /> �-• n C CONTACT INFORMATION <br /> �J <br /> OWNER NAME: :ew as R Q0 TENANT NAME(If Commercial); <br /> OWNER MAILING ADDRESS: STREET . i f 1 Ti 0 <br /> cm -& STATE 2rP ' I &ea 1 ' <br /> OWNER PHONE: PO l p (Q/ q (a3 OWNER EMAIL: . — <br /> CONTRACTOR NAME: fla S`- i. AA S-!,T f ^ <br /> CONTRACTOR ADDRESS: 9TROET I r P .—iy S LI D(p • <br /> crrY to V 1,1 1- L.1---' STATE , A. ZIP « b <br /> CONTRACTOR PHONE: I2 S to 5�p a"1 CONTRACTOR EMAIL:f 1Z,V' a S () 13rvoiC,Y -�air, (,cwo <br /> CONTRACTOR LICENSE#A(REQUIREI3k fAS w0CILi R.)3C CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)5 L15 J <br /> PRIMARY CONTACT: 0 OWNER keONTRACTOR 0 OTHER(Please Speclry) . . . <br /> CONTACT NAME: ICA <br /> Gtr CONTACT PHONE: LI 3� <br /> lam` :Vi ��-'C'��� (CONTACT EMAIL: �?'e/16(A 1'� -e6 si--01.}e,Ir r. CA:5vvi <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$, -.�,� <br /> ProyossdUse orBuilding: _s1 K _ Heat Source: s ❑EiectrIc DOther <br /> Buildinge:T I PR-Detached ©SFR Attached ©Du.lex ©Multi-Famll -i of Units- I!Conimerclal CI Industrial <br /> ,Type of Project I:Mew ClAddltIon CIRemodal l'24 Repair 1:111/._' EISign ©Sprinkler 17oernolltion COChange of Use <br /> ESCRIPTION OF WORK ' <br /> Finn 0\ie l re,p\ c,e, A,, s wem-- \Aca:-t <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> MECHANICALPERMIT APPLICATION PLUMBING PERMIT APPLICATION ��• <br /> Type of Project: New _ Addn _Alteration Repair Type of Project: _New _Arkin _Alteration __Repair <br /> #of <br /> !"/xturas List of FixturesFixtesu List of Fixtures , urs List o I urea Fixtures <br /> Vat of Fixture: <br /> N C-AlrHandling Units Heal Pump / Toilet Backflow PreVent:� Heide Bid! <br /> • Forced Alr Systems Unit Heater Bathtub Urinal <br /> \ 0Gas Piping Boller Lavatory(Wash'Basin) Drinking F.. tale <br /> Water Heater m... Refr eratlon I Shower Floor = n <br /> Gas Fireplace Wood Stove I Kitchen Sink&Disposal GP =ee Trate <br /> _,Gas Rare - Ducting • Dishwasher oof lJi•ains _ <br /> Clothes Dryer Hookups - Other: Clothes Washer dlcal Gas <br /> Range Hood - - Water Heater - Oth; • <br /> Exhaust Fan Sink(SeNfGe/BarlMop(�tc Other. <br /> . $P IN L.I:R--SUPJe��s$lo TAT M <br /> etmloal ar Wates ' 1 .of Heads _ _ ` <br /> ACKNOWLr_DGEMI NT:I have reviewed this application end confirm the lnformellon contained herein Is true and conrecf.Work done pursuant to this permit must co . with <br /> current faderal,state,end local tem rhea granting ole permit only authorizes approved work And no deviations therefrom.Deviations must!fret be authorized in writing from the <br /> dulldIng Official before being authorized under any clroumstance.I em the owner,or I em authorized by the owner of This property to perform the work forwhlch epnllcatlon Is made. ' <br /> and/comply with Ilia Stela Contractors Lew 18.27 RCW end 299,240/4 WAG. <br /> City of Everett Official Use Only <br /> tixli j . <br /> PERM1IV'\(I I <br /> Own uthor zalA <br /> r,t Signature Date (Rev/sed tr/2312o1Q ®........." <br />