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#111111 -271 <br /> PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN! SPRINKLER! DEMOLITION <br /> `w__ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 96201 <br /> (Pi 425-257-6810 l FAX 425-25?-867 I t-)3.ar,.ttsas'dleveret�va gov I www evsrettwa gwrpermi`S <br /> (Brae or, <br /> Black (n1tOniy pleas} <br /> 'PROJI=CT SITMA�{at�I� _ <br /> PROJECT SITE ADDRESS:._ 00Q T 17J <br /> for new const; 1' Ave L) n} " TAX <br /> PROPERTY TA #: <br /> LEGAL <br /> construction: Short r'lat'>ct;tw;;;o,rt <br /> ___ ___ __Lot No. (attach copy of long legal description) <br /> CONTACT-INFORMATION <br /> OWNER NAME; .—.9 <br /> OWNER MAILING ADDRESS„ -• _ i A# ' TENANT NAME(tf Ca <br /> ..,* Commercial): <br /> _.- STZ_c:y 39) \ �`�. <br /> k' <br /> G 04111 0 <br /> STATEWilicr''' n <br /> OWNER PHONE: `3 t---7 <br /> I., OWNER EMAIL: <br /> CONTRACTOR NAME: "ri l-' .•, t¢"I C <br /> CONTRACTOR ADDRESS; 1E41 <br /> { <br /> STATE \A) <br /> ZIP 1 • <br /> CONTRACTOR PHONE: I-1,5 q. D • <br /> '.�C� .CONTRACTOR EMAIL Q � � a <br /> - - -�'N�Ti�AC�Ti`�Ri-L-ICENSE��{f�cEt3;JfREf�3r�'�°� r - .f j <br /> "_.. tY°Y <br /> OOP EVERETT SU:i#VESS L10ENaE';,•(REQUIRED)t i L}u7'-1- , <br /> PRIMARY CONTACT: 0 OWNER t6ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: (CONTACT PHONE: 1...1.2.6 25 C1 0550-0 <br /> CONTACT EMAIL: • ! <br /> 'B1,J1LbiPIWPERM('i' F14.4r:: 1004 ' -41:4T.t-t , <br /> Exiatin Use of Burldin•; <br /> Contract Price of Work:$_2.... .00 <br /> aposad Use ofBuildin,: <br /> Heat Source: *It 33 ❑Electric ❑Other <br /> Ssu,fdin� T pe: ©SFR-Detached O�.F'r 4 e-tthe f a_ -.- .... <br /> ODuo ex DMulr. <br /> t Famsfy-#*FUnits: OCommerc�,. <br /> �` P�of fo oe"t: ❑New ©Add al ❑(ndustrial <br /> ifiorr ❑Remodel t�R o�:r OTT ❑Sign OSpnnkle, C7Dsmolition ❑Cha,to of Use <br /> T pe of DESCRIPTION OF WORK: <br /> 14,410 ---(),c.e.... S AS f-- U„trn&C.R___. <br /> ASSOCIATED BUILDING PERMIT#(ir aopii tad.ge); <br /> MECHANICAL PERMrr APPLICATION <br /> Type of Project: New ,,pLumaiNa"PCRIviiV1 POLICAT[o <br /> Addn Alteration <br /> #of Repair Type of Project: New <br /> #of Addn Alteration Repair <br /> txRar$s 1 # ixltrres _ LtsZ ofix;dies _ #of <br /> F [lura_s fiixtfrrss --S fst•®f�Jxurs-- #of <br /> A/C-Air lianrllin (mitafixtures <br /> IMII Forced Air SystemsIII Heat Pnmr Toilet <br /> BaNM Unit Heater BathtubUrinal Preventer(Inside Bldg) <br /> Gas Piping - -- Urinal <br /> Boner Lavatory(Wash Barn <br /> )Refrigeralto�� Drfnk;n Fountain <br /> Gas Eireplace Shower Floor Drain <br /> `1Vo©d Stove DKitchen Sink&Disposal <br /> C?tlrtirrg Grease Trap <br /> Clothes Drier Hookup, Cloth cher <br /> Roof Drains <br /> Ran.e Hood Other: ME Clothes Washer <br /> Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION Sy& E <br /> IMChemical or Water <br /> No.cf Heads .111111 <br /> ACKNOWLEDGEMENT:I have reviewed this application end confirm the information contained herein Is lrue and correct.Work done pursuant to this perm*must comply <br /> current federal,stale,and Jocal law. The grarlrng c/a perm((cnfy aulhcrizes approved <br /> Building Cffida/before being aulhcnzed under any circumstance.I am the owner,er I air;authorized by the owner cf this property to perform the work for which a nli at/coh <br /> and I comply with the Slate Contractors Law 18.27 ROW and work and no deviations therefrom,Deviations must Brat be aulF,onzed in writing from the <br /> 296,2G0A WAG'. p ,ismade, <br /> City of Everett Official Use Orly <br /> . PERMIT# <br /> Ow �r__re ,1 t aill M l / 'D J <br /> er1Au#hariied Age Signature -) <br /> (RaVrstid 7i' � 06). <br />