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PERMIT APPLICATION
<br /> /Loii,„, ,.,, BUILDING I MECHANICAL!PLUMBING/SIGN/SPRINKLER/DEMOLITION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 0ri44...,
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P}425-257-8810 I FAX 425457-8857 I(E)everetteasaeverattwavoy i www evareitwe gostportnts
<br /> -- sessseststiiiissitte tti• •
<br /> Blue or niack Ink On PI :.,-,,170,,,f?,,,;::„'-1:K:A:::=717L7;,:".., •:,...., , ,. „,,,, -
<br /> PROJECT SITE ADORES& : L0 ...,-Cie°t ' Ve,.. PROPERTY TAX a:
<br /> LEGAL E.e.Tlew corstreten: Short Piatesundiyiston LZ):N;:, tattann copy of kin9 et1B1descriPfen)
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<br /> #OWNER NAME: l, F"i',..... C.,,isTh.F;;A/A iC„-,A....... TENANT NAME(fl Commercial):
<br /> OWNER MAILING ADDRESS:
<br /> ,,„7,',•,,,, ,,,,,,,,,,,,,,,,,,,,;, Ck/.5}:"7-‘?-7?-1 "OWNER EMAIL: --"-------
<br /> IP, NWBATHWORKS,LLC
<br /> 18824,1TH AVE NE
<br /> c,, ARLINGTON S,ATE WA ZIP 98223
<br /> tiONT*40014)00 , i•,.', 425-418-9M5 ,,
<br /> 1`,1*(StgitplcI,Sr,,7, ' d',
<br /> ,, NVVBATHWORKS@GIIITAILCOM
<br /> NW8AT8L855PA CITY OF EVERETT BUSINESS LICENSE fdRECtudaEoy 57184
<br /> PRIMARY CONTACT: DOWNER 0 CONTRACTOR 0 OTHER rPlease Specify)
<br /> CONTACT NAME: CONTACT PHONE: ' ' .... 3-2-7-
<br /> tAir Is, 6,, CONTACT EMAIL:
<br /> ' '''' ''''" '''''''''''''''''-i'''"•'''''''''''''''"' ''''1'IMO PORMITAIHILICATION
<br /> CordactPrice of Work:$ S'l'II?Oft
<br /> Proposed Use of Building: jfifiett Sostat CIO4 --CIP,Iiki* 0/1k1kr7,-,414::,IIS"hii:
<br /> ,::.,, ,..-„,..fliit,0•:ti:', ,t,;.''':',' OSNIA/00* '000iiki ••CIM4FION-Otttliz.:,-;—i.....,;-.4 oll',*,..,,i,t,---,' ''*F•,.".trft t--•
<br /> Type of Project ONew E3Aeffition ORsmodel 0 Repair Di i Cl&gn Osennider ODernolition Dena,:ii e of Use
<br /> DESCRIPTION OF WORK:,
<br /> ASSOCIATED BUILDING PERMIl applicable):
<br /> MECHANICAL viitivik#464444ittost4 ... . #400,AtiSlit44r, t.:!
<br /> Type of Project New Addn Alteration Repair ' Type of ProffaM New « Affffa ;:44.PIPIArp
<br /> 4 of 4 of
<br /> List of FIxtures Fixtures Li6t of Fixtures Fixtures-- i List of Fixtures
<br /> Fpaures
<br /> Fixtures
<br /> /VC—Al**1000gIliiTi* .h eat PurnP ''T9filet Backflow Preventer(insgle Bldg)
<br /> Forced Ait Systems Unit Heat& , Bathtub Unnal
<br /> bits: el,‘, .......
<br /> Scour Lavatory(We h Beam) Drinking Fountain
<br /> t.,,,
<br /> 1 -YY:a*It,--;';:'' ' : Refrigeration Shower Floor Dram
<br /> ,64tift*r*I''' Wood Stove Kitchen Sink&Disposal Grease Trap
<br /> 008,,r41' ::' Duch t •
<br /> Dishwasher Roof Drains
<br /> '1:':''q131Z:Lil':'-; Other Ciathes Washer
<br /> Range -4 linod I.;7',-Ta‘,-.71. Medina!Gas
<br /> Other
<br /> Exhailek.Fan Sink.IService/BariNtopietc,)' Other
<br /> ""t"/,'I St?PITEISSION SYMIRA,
<br /> _,!".'',7.,1•'•fli:::;00100 I IN. of Heads _
<br /> ':--"..,',..,jr,TZ'',.,-,1,tipI'-' :t:7';;v-''.„.';';''':'-'i'f ,4,,!7'.!,,,.,.,t,7:1.1' ..: ******t. '• 4****010/4'..!5P.00401.0#,,,-
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<br /> satift*firkiffk°:.,:::-.r...,-.,'::t..,,,..,',..,-,, -.-'',(!:!,-.75:''',,',S.:•:,,1''''
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<br /> , 16- 2
<br /> •
<br /> Ownoriiikethe,250-1t Signature Date
<br />
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