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HERMIT APPLI ATI®G :0001.00.. -UILDING ECHANICA / PLUM fINV SIGN/SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES M 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink ;.,my Please) PROJECT SITE I i,FORMATI I N /� F /� Meg > �^ fir-�L /��s /1 �q PROJECT SITE ADDRESS: -!q z 1 )"1 +A k `fir/, e 1 rI PROPERTY TAX#:'210,7 OO 3 P ee. LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: .aidvir / r TENANT NAME(If Commercial): kr A 0 + .404, OWNER MAILING ADDRESS: STREET el 41 3 I Wv% / cut CITY v e Ks'ft STATE V/k ZIP q g v.!',�," OWNER PHONE: `a 0 b) ;;19 �- 1419-4 OWNER EMAIL: S MA, C (Al"V EIs1 I.�G Iv CONTRACTOR NAME: Toe- -1- -4.V1 Cok -C-rvlettrairl , �G i , CONTRACTOR ADDRESS: STREET / f^ * gli-Ituv '&Et CIN "F t -e) STATE Wit ZIP ei 0 4 CONTRACTOR PHONE: (2 s.) bOb r il'2S" CONTRACTOR EMAIL: ) i 1 ic..-8,j Di?114/71 1 46 jity CONTRACTOR LICENSE#(REQUIRED): oTOe[t ' ,2.S'"l rl CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR IIS OTHER(Please Specify) A tzc ITS(T CONTACT NAME: }� i�" CONTACT PHONE: 1/4 2.5') j�tl4.0-., 2 4 'r' i'f i i f RQ 1, 'a r 10lf CONTACT EMAIL: o^lo/ 1- ,01 e7 I yi''.t �l mG ' cokyi BUILDING PERMIT APPLICATION 1 Existing Use of Building: Z}tt i I FL2 C *�a+O`V'L Contract Price of Work:$ 5;600 Proposed Use of Building: VY►e. Heat Source: I]rJGas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: IEiCommercial [Industrial Type of Project: ❑New DAddition ❑Remodel ❑Repair eT.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF, 'ORK: �t �►�'- I �e„ c Int _ ASSOCIATED BUILDING PERMIT#(if applicable): 13 i "QL4 I MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration Repair Type of Project: _New Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater _ Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas r Range Hood _ Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water I No.of Heads 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only I PERMIT# 1/...-., 4, P 1 lb, i e 1,19 /MigV-0/? uthorized Agent Signature Date (Revised 9/23/2016) Cli------ xj