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El <br />BULDNU i uv(ECHAGv1ICA, , I PLUM NG 9 MGM - E RUNKLER I DERM©U`1 IO <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everetbiva.gov I wvvvy-everettwa_gov/permits <br />(Blue ©r Bilack Onk (OonIly Ph-D2s:re) PROJECT 5 9Ti'� 9NFORMAT90NI <br />PROJECT SITE ADDRE S: IL If C:�-� 4 GY z y' .; r <br />PROPERTY TAX #: <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) 7/VG: ;;. <br />CONTACT 9NFORMA IT9®119 <br />_ <br />OWNER NAME: ��''. Cif�t f ..� �;tL? TENANT NAME (6f Commercial) r�-j/ � •:�Jt �'0,� j s!% <br />y <br />OWNER MAILING ADDRESS: STREET <br />CITY STATE ZIP <br />LWNER PHONE: a�'...s <br />OWNER EMAIL:l,>?�L z Bea <br />CONTRACTOR NAME: 7843 <br />1CONTRACTOR ADDRESS: STREET <br />I <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: J OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) I <br />CONTACT NAM: <br />_ <br />CONTACT PHONE: u;? .`a *�? r 6 <br />CONTACT <br />B@ IL109N0 PERM11T APPLICATION 1 <br />17 <br />Existing Use of Building: �.S'4r�r ciiia 4 Contract Price of Work: $ <br />Proposed Use of Building: /f IF T/'Va p..a n. Z Heat Source: 41Gas ❑Electric ❑Other <br />I Building Type: ❑SFR-Detached ❑SFR-Attached []Duplex ❑Multi -Family-# of Units: gCommercial ❑Industrial j <br />' I <br />I�Type of Project: ❑New ❑Addition JDRemodel ❑Repair ❑T.I. []Sign ❑Sprinkler ❑Demolition []Change of Use <br />DESCRIPTION OF WORK: % / <br />S1J�1-G°�2� <br />7X <br />11ASSOCIAT ED BUILDING PERMIT # (if applicable): <br />iI V�ECI�ANICAL PERlildlii APPL11CATION <br />t <br />PLUMBING PERMIT <br />APPLICATION <br />Type of Project: _New _ Addn _Alteration <br />_Repair <br />Type of Project: _New <br />Addn Alteration ZRepair <br /># of <br />Fixtures <br />List of Fixtures I <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C -Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater j <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler j <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />I <br />Shower <br />Floor Drain j <br />Gas Fireplace jj <br />Wood Stove I <br />Kitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />Dishwasher <br />Roof Drains <br />Clothes Dryer Hookups <br />F <br />Other: <br />Clothes Washer <br />Medical Gas <br />j <br />Range Hood <br />Water Heater <br />Other: <br />I' <br />Exhaust Fan <br />cS` <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />1 <br />SPPI 91N' KLER / SU PFRESS[10 , <br />VYSTEM <br />Chemical or Water I <br />_ <br />No. 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 Official 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 18.27 RCW and 296.200A WAG. <br />City of Everett Official Use Only <br />5��'IOT <br />PERMIT # <br />Agent Signature Date \^ (Revised 912312016) <br />