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PERMIT APPLICATI• ► <br /> ssil/ BUILDIN�VIECHANICAL/ PLUMBING /SIG 'I 'RINKLER/ DEMOLITION <br /> I�� CITY OF EVERETT PERMIT SERV <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) - PROJECT SITE INFORMATION ,.: , <br /> PROJECT SITE ADDRESS: 'gam <br /> C 1W q j PROPERTY TAX#:CCLI1i2I-OUiOZyQJ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT;INFORMATION... <br /> OWNER NAME: 1310/1 ??;2.2 Pmer►t5 TENANT BUSINESS NAME(Commercial): et'wG,v In clivaiAt.g.. <br /> OWNER MAILING ADDRESS: STREET=i 0615 I)c a+cui �i I v(1 51446 b <br /> La VV! <br /> CITY 1 a 3 V t'c STATE N V ZIP tr/65 <br /> OWNER PHONE: V OWNER EMAIL: <br /> CONTRACTOR NAME: kV( S qr CO'r't ' v , <br /> CONTRACTOR ADDRESS: STREET ZU'u( NNtu1) -1 q 5- <br /> CITY d't OIAA4 Vefrt • STATE WA- ZIP qv--73 <br /> 3 <br /> CONTRACTOR PHONE: 5(w-Li 2.1- (?.)-5 CONTRACTOR EMAIL: 34JU iitt p V - t'r5►40 r a;vv-) <br /> CONTRACTOR LICENSE#(REQUIRED):MEviG9_Ls 3� CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 5 73) 0 <br /> PRIMARY CONTACT: ❑OWNER paCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:` CONTACT PHONE: WO ti del i 5;c <br /> 1 1, <br /> V titAl � k f\iI q IAds l CONTACT EMAIL: Sire� /41t li metiers-1'4A 1 ,. Gl. <br /> 1 1 <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$_2'OO,. 00 <br /> Proposed Use of Building: Heat Source: OGas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair DTA. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: \/ till11\9 i !` i 1k, 14\11 j watt S i 4 4 ` z4. vy\ef <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MEC_HANICA_ L 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 Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain 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 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 WAC. <br /> ? City of Everett Official Use Only <br /> 3 /� 17 PERMIT#�- �0y©c/' <br /> Owner/Authorized ocifl <br /> gent Signature Date (Revised 10/10/2018) J <br /> i t/2_ <br />