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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING /SIGN /SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps©everettwa.gov www.everettwa.gov/permits <br /> Ike or Black Ink t l Plea <br /> „ ,� � PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS., /. ,VOW SF <br /> *165 PROPERTY TAX#: 51C,$,ro <br /> it rGAL for new construction: Short Plattsubdivlsion Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: :r r� !• _ <br /> ,art p- 4.0411 TENANT NAME iAll"Ccir±ilmarcial <br /> OWNER MAILING ADDRESS: STREET E' e95 Agfjpg- <br /> Cr, $TATE ZIP _. <br /> OWNER PHONE: + `V$-923:' p OWNER:EMAII: merit '>•. S�"',�'.'A - .c <br /> CONTRACTOR NAME CO • ' ' ,SNE I2cOF//V 1NC. <br /> CONTRACTOR ADDRESS! STREET 17(021 /5 i At fes. S+£ ,,1 <br /> Cm . . E / <br /> d ' L4- STn7E W4 _ ZIP 9e0f1Z. <br /> CONTRACTOR PHONE: 4;06-. AT- CONTRACTOR EMAIL' 0 f *.o. <br /> CONTRACTOR LICENSE#(REQUIREQI; CORA/ tiOf ali-CornCITY OF EVERETT BUSINESS LICENSE#04teautaeoy 0336-.4. <br /> aRIMARY CONTACT: ❑OWNER Cr}'GcONTRACTOR 0 OTHER(Please Specify) <br /> :ONTACT NAME: * CONTACT PHONE: y85—D�// <br /> K r 1 eo I . ' CONTACT EMAIL ►"�"` ` ° .d` r r, <br /> BUILDING PERMIT APPLICATION <br /> Existi,i Use of 8A:M4: Contract Price of Work:S`: J 1''4 2 CP <br /> 'ropos d Use of Building; Heat Source: ❑Gas OElectric ❑Other <br /> Ittildtng Type: I FR-Detached ❑SFR-Attached ['Duplex. ❑Itilulti-Family of Units: OCommercial ❑Industrial <br /> •e of Pro-ect: [New ❑Addition ❑Remodel QR:= OT.I. OS`t; C Seth tete D olition ❑Charf•e:of Use <br /> )ESCRIPTION OF WORK: <br /> f vE 774-6-Ro�/N6i ire.pfri-ee !Tl/5 //95/211-41-44 <br /> tSSOCIATED BUILDING PERMIT#(if applicable <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERM1' 'APPUCATION <br /> ype of Project: New — Addn _Alteration Repair Type of Project: New _Addn Alteration _Repair <br /> 04 List of Fixtures #of #of <br /> :ixtures Fixtures List of Fixtures #°f List of Fixtures List of Fixtures <br /> Fixtures Fixtures <br /> A(C-Air Handling Units Heat Pump ToiletwBakll+ tnr Precentor(Inside'Bldg) <br /> Forced Air Systems -' Unit Heater oathtub: Urinal <br /> Gas Piping - Boller Lavatory(Wash Basin), <br /> tlrirtitirtg Fountain <br /> Water Heater Refrigeration <br /> Shower Floor Drain <br /> Gas Fireplace Wood Stove <br /> Gas Range Ducting Kitchen Sink 8 Disposal arse Trap <br /> g Dishwasher ,ERoof Drains <br /> Clothes Dryer Hookups Other: Clothes Medtc l`Gas <br /> Range Hood Water Heater Other <br /> Exhaust Fan <br /> 'Sink rviCatigarifvlpo#etp> Other <br /> SPRINKLER/SUPPRESSION.SYSTEM <br /> INumber orHeads K <br /> :KNOWLEDGEMENT:f have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> '111011000,01;4fate,anAlocatdsw.• The granting of a 1entsit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> dklirrg ofPcial before beingauthorized under any cirbowisfence:.lam the owner,or l am authorized by the owner of this property to perform the work for which application is made. <br /> d!comply with the State Contractors Law 18 27 RCW and 296.200A WAG, <br /> City of Everett Official Use Only <br /> PER # <br /> jos of 2 <br /> Rarer Authorized Agent Signature ate (i , tt,: € 030 <br />