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I I <br /> PERMIT APPLICATION <br /> ,111:—A BUILDING I MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-82157 1(E)everettepePleverethreLgov I www.eversttwo•gov/perrrllte <br /> PROJECT SITE INFORMATION <br /> PROJECT <br /> i 00 +,,, 1,044-...ssPOPERTY TAX/- OO S O S$00000 So3 <br /> LEGAL for new construction: Short PletlkubdIvialon Lot No. (attach copy of Iona legal ds criplon) <br /> CONTACT INFORMATION <br /> OWNER NAME: 54-.,vw., Lel4i TENANT NAME(It C°mm"'cisl): <br /> OWNER MAILING ADDRESS: STREET 51'q k 1/ /1h.�4a.r 41,1 Or <br /> cm (NSIl1 <br /> w 1 STATE (A ' /*95-5-1 <br /> OWNER PHONE: 17c—940—gg49 'OWNER EMAIL 611.w Iola @ .11, ., <br /> iCONTRACTOR NAME 6, hJ„4. L4-r`54+I-C�LTA CT-11 — r C <br /> CONTRACTOR ADDRESS: V ti,, <br /> sTET t 0 07 (4-C41-(04,1 U ce--.) G•./ . <br /> cm' �r 1e,Ar'-_ -�- STATE Li C.1 5'�C� <br /> MORE:ONE '7 25 7 `2 JCONTRARTOR MAIL JO L-1,hi p,,,I/...., 1 _ce,l..-4,- - <br /> CONTRACTOR UCBISE O(REUUIRFD): t-t-OS A-1`h •I o t( K A Jail►OF EYIERETT BUSINESS LNC=NSE [oURED): <br /> 'PRIMARY CONTACT: O OWNER II-CONTRACTOR 0 OTHER(Please Spedly) <br /> CONTACT NAME: i / CONTACT PHONE: Zi25—76 2, O _ <br /> 11-4- Vc1,`v•-•J`CONTACT BAAML _� -._-�G„ G OST. <br /> BUILDING PERMIT APPUCATION <br /> Existing Use of Bolting: .Contract Price of Work$ s',�(2a <br /> Proposed Use of Building deet Source: OGas DEIeWIc O011aw <br /> Building Type: DSFR-Detached OSFR,Atiached OD piex 0Multi-Family-#of Units: OCommerdal Olndustrtal <br /> Type of Project: ONaw DAddlbon ORemodel *kept* OT.I. Deign OSprinider ODemolltion °Change of Use <br /> DESCRIPTION OF WORM . <br /> Qerbo‘ e :" �no'� t <br /> BUILDINGMI <br /> ASSOCIATED BUILDING PERT•CIF>4-4-a:": <br /> ppRce <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Prefect _New_ Addn AII.raeon_Assists Type of Project _Now Addn _Menem _Repair <br /> e or /Of /ofList of Mauna a List of Mewls <br /> Fixtures LtetalFtSrahrea Fbdraos [Jstartixfarw rheum Fief es <br /> AlC—Air Handng Urals Heat Pump Toilet Backflow Pneventer(Inside Bldg) <br /> Forced Air Systems Una Heater Bathtub Urinal <br /> Gas Piping Boder Lavatory(Wash Basin) Drinking Fountain <br /> Water Healer Refrigeration Shower Floor Drake <br /> Gas Fweplace Wood Stove Kichen Silk a Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other Clothes Washer Medial Gas <br /> Ra1Qe Hood Water Heater Other <br /> Exhaust Fan <br /> Sink( ) Other <br /> SPRINKLER I SUPPRESSION SYSTEM . <br /> !Number of Heads <br /> I have wowed this apples:km and confirm the thbnned n careened hreh Is true end awed.Mork done puttied to 011e p.mth must cote*wlrh <br /> anent kd.rd,alias and load I.wt The groniew ofo porn*only authorizes approved work and no deviations t ha..Aont Do one must but be nut hoar d In%way from the <br /> Dukes;Waal Wont being ark honored under any ohxnmtwoe.I em the curler,ort an authorrasd by the owner titbit prcprty to wawa the Nom for Oath arpiorb+Is nude, <br /> and I comply eft the Share Contractors Law 18.27 RCW and 2e&200A WAC. <br /> Qty ciEvened MUM tree only <br /> PERMiTAF I (a b ( - 025 <br /> etyperwae:„...52_ <br /> { �,vZ,r6 <br /> Me (Revised 10/12,20111) <br />