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Imo PERMIT APPLICATIO <br /> ILI <br /> BUILDING MECHANICAL/ PLUMBING / SIG1 7 SPRINKLER/ DEMOLITION <br /> EVERETTCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: Cp 7 Z 7 fve 5/'e.,, (,J 0 y PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision l / Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT BUSINESS NAME(Commercial): 0(1 1,6 b <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> el <br /> CONTRACTOR NAME: lA I,(•eel PI(AM b <br /> CONTRACTOR ADDRESS: STREET I L —] ie I y ST SC; 51,(÷c 13/ 7 <br /> CITY Yvl ©r 40 C STATE ZIP 9:92-3-'C..-- <br /> CONTRACTOR PHONE: (31.:9-) -7 g-( 5Cr-) CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED):lAn)'T L{7 *ft/ fj lz) CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ej( 2j4 ' <br /> PRIMARY CONTACT: 0 OWNER ,FrnONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (' / -i) 37 7— 5 7 G <br /> 'DAP Ck Vtik CONTACT EMAIL: 'Ua," C (-t'K tt<a 0,,,,,,,b,n5 • CCS•a,,, <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$ ;(J ), 60 o <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: DSFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial DAccessory Structure <br /> Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: M c24^ I. W- e._h �c"--kk ie..o..s1J I 0-/Gee S i r^ 1C °L Go k,-e/ I^e� f'-� <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Of q 0( - 61,72 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer ISink-Commercial(3-comp,prep,floor) <br /> ' <br /> Clothes Dryer Heat Pump&Ductless Dishwasher A Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration ( Drinking Fountain ,4,--/ Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation 2_ Floor Drain 5. Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb / Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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 bet, e being a orized 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,'e State Co tractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> j PERMIT# ,F(qQ5 OO <br /> 1 C/3 <br /> Ow -r/Auth• Ize• gent Sig ture Date (Revised 4/15/2019) <br />