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PERMIT APPLICATION <br /> BUILDING /MECHANICAL I PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> ,r#P <br /> 1 CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-885742 I(E)everettepsl everettwa.gov I www.everettwa.gov/permits <br /> Stolt or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2402 5i56,14148 5k) PROPERTY TAX#. <br /> ,LEGAL for new construction: Short Piat/subdtvisl,n Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> ANIMMINNIIMMOM*. 41010101.1.1110111111101101/1/111111111111001. <br /> OWNER NAME; .-reieE.S4. . .t TENANT NAME lit Commercial k <br /> OWNER MAILING ADDRESS: STREET 40.-n, e. #6, Adotte- <br /> CITY - <br /> .. ...... _ STATE ZIP.::: ..... <br /> OWNER PHONE 204- 456-'2a-71 OWNER EMAIL: 721Jrielittialeo t=f0 Ai, •,i i ed7r7 <br /> CONTRACTOR NAME CD <br /> + /L:12 ks7ivE' .iG�rlN,6 I NC• <br /> CONTRACTOR ADDRESS: STREET 174,2y /d- #1-42i4 <br /> CITY /D f�-• '"� / <br /> �/�J .i� STATE it44-.. ZIP 947:),Q, <br /> CONTRACTOR PHONE. , <br /> �� -- ! CONTRACTOR EMAIL: `t l0. ,r- a*, <br /> — - r. Jtt �:Ccrr7 <br /> CONTRACTOR LICENSE#(REQUIRED): CZAtE 0jCc CITY OF EVERETT BUSINESS LICENSE#(RECJIREO): 038 6-6 <br /> aRIMARY CONTACT: 0 OWNER Gi'eONTRACTOR 0 OTHER(Please Specify) ,. <br /> CONTACT NAME: ;CONTACT PHONE: y26-_ 01/4715-...-O/// <br /> K 1 v.'s'j � "" AN A �1 CONTACT EMAIL. <br /> BUILDING PERMIT APPLICATION <br /> wxiistin• Use of Building; it. Contract Price of Work:$ , ., `_•OD <br /> ,roposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> 3uilding Types 126FR-Detached ❑SFR-Attached ❑Dtyiex ❑Muth-Fatnitr: of Units: ❑Commercial ❑industrial <br /> ieme <br /> 'ype of Project: ONew 0Addition ❑Remodel ORepriv DT.I. CI Skin ❑Sprinkler ❑Demolition °Change of Use <br /> 1ESCRIPTION OF WORK: <br /> f5'� <br /> �s t w 4 a�,� <br /> ►SSOCIATED BUILDING,PERMIT#of a.•'I.cabie2: <br /> MECHANICAL.PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> ype of Project: New Addn _Alteration Repair Type of Project: New Adds _Alteration Repair <br /> hof #of <br /> List of Fixtures <br /> -ixtures Fixtures List of Fixtures of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures <br /> o <br /> Forced it AiHaSndling <br /> nits _Meat <br /> 'Unit Heater Toilet Backflow Preventer(Inside Bldg) <br /> 9 . <br /> eater 'Bathtub Urinal <br /> Gas Piping Boiler " L vatoryr.(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower ' Floor Drain <br /> Gas Fireplace Wood Stove +'Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups "Other. Clothes Washer edical Gas <br /> Range Hood Water Heater ;MOther: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> FIs ttYrl tat ads <br /> :KNOWLEDGEMENT: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 /> Trent 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 /> rflding OrTciai 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 /> rd I comply with the State Contractors Law 18,27 RCW and 296,200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT <br /> !f '.. _4:14....,44.- 1---.r:' '"1 Gf <br /> ones Authorized Agent Signature Date <br /> (Revised:SA2tiJ2&d tt$J <br />