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BUILDING ( MECHANICAL EPILUMBINGCATfON <br /> I SIGN(SPRINKLER( DEMOL#TION <br /> Nor' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)4Z5-25T-8310 I FAX 425-25T-885T 1(E)ava 3tt pspevar 3ttwa,gav I 'wvw.everettwa.gov/permits <br /> (Blue or;Black Ink Only Piease4ri <br /> 'PROJECT r # `EMirilti41A`1`irNf�= :_ <br /> PROJECT SITE ADDRESS: a. <br /> LEGAL^:sr naw aon;tntc'ian: Short Pla'is a'dI .,€a,, PROPERTY TAX fO: <br /> -- - _ Lit No. attach copy _. _ <br /> t of long legal description} <br /> � �„, CONTACT=INFORMATION <br /> OWNER NAME- 1 Allk (1 <br /> .4.v ..rt TENANT NAME(If Commercial'): <br /> OWNER MAILING ADDRESS: ; _._ 40 IC Ci S <br /> Ala <br /> OWNER PKONE: /3! r Q ''� �> �4LJ <br /> • U OWNER EMAIL: <br /> CONTRACTOR NAME: -` " int"' t C <br /> CONTRACTOR ADDRESS; 14 /y cL�rt^ <br /> • <br /> CONTRACTOR PHONE: t� o STATE Afi- ZIP f : 20 I <br /> C+N FfA6 Gpi n o CONTRACTOR EMAIL-s#,•,4 l, ' 0 tik no .co <br /> PRIMARY CONTACT: -GtTY'Or'e1tR@YI 8t#53NtICErii3c#(RE4VtRED. . t ' <br /> 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> 'F1�'^t^ CONTACT PHONE: Lt.2.5 ZG9' 055D <br /> 1Jy�y�J CONTACT EMAIL- •J ✓t� <br /> wxistin Use of 6' •,*,'ldft - , ,Aituit;Dtt'G ERM1`i`iAmitad it's i ,r' ° ° <br /> Contract Price of Work:$ \ O 0 <br /> ' loosed Use of 8uildin : <br /> Su 3ditt T t-t - <br /> P 3 =d -OeEach3d Heat Source: NO'as ❑EI trrc DOther <br /> D3F A't3 hyd <br /> ODudiex 0Multi-Earth€ 4 of Units- <br /> T Yom of P aJ3 t: ❑N9w ❑Addition ❑Remod=_I QR9C33T= k ---- OCommzrclal OlndUafR3I <br /> DESCRIPTION OF WO K: ErlTh 0Ed,n t73prinklerr ODemolition E$' ban a of Us3 <br /> c21000.....CL,.. Lk Re13-5\0 VI CaaS V.,40 - Ck) CukOr <br /> ,_ <br /> A3SOCIATED BUILDING PERMIT f,f(Fr a33ii a)[e). I 1—CA4A-k, <br /> it+1r:CHtINtCAeF`EFttVitT APPLICATION ' <br /> Type of Project: _New .,, . <br /> Addn Alteration 4 < N:UMBaIit�iEIV� ' P.ta?ttG1�'t"tCi3�1 <br /> _Repair <br /> IA of <br /> #of <br /> ' ^' —tJst of FtX& es— #of#isr"iug Fixture <br /> sIMMINAIC-Air Handling UnitsMMIN. <br /> MR Air S stems _Toilet <br /> ME innGas Forced ird Bathtub 111111111111111111 1.11.0 (3acktlntiv Preventer(Inside Bid-) <br /> NUN Water NestorLavalc�ry(Wash Basin) <br /> Miii Gas Fireplacemon Shower Floor Dr FountainWaod Stoveman Kitchen Sink&dis.osal Floor Grain <br /> Clothesmon [3 or Hookups Dishwasher mom - <br /> Ran.e Hood ether:1111.11111 nom Clothes Washer Roof Drains <br /> 111111111111111111111 Mther: <br /> �allin� / fir ,�Slnk(;�ervfcet8ar/Mc }etc. <br /> f!' INKi. i�t1 Other:. <br /> SUPPRESSION SYSTEM <br /> Chemical or Water <br /> e1PiC4V Nc.cf Heads <br /> d ECGEMENT i have reviewed this eppi alio and confirm,ll;�, on IIMINIIIIIIIIIIIIIMllmi <br /> ccntaired 1:dretn Es true and correct We done pursuant lc this e <br /> ro�rrasnt iedarai,stars,and iccatlawr me grant€rtg ci a germ{tri <br /> att7dtr C„ .y tam <br /> sF of work e and no deviations s ih r offrwn Deviations must first he authorised r.wrtlin fTc+rr rtr- <br /> 8 Hera4 t are,and <br /> heiis authorized grard irr v f arum isrca,i uthe authorizesarceder,r ! r.,p-sed must nfroy Witt. <br /> and I cernCt t with the State Contractors Low 1 a f"r.tw,v;d 2se,1Cmt a C. <br /> ottani nrr;oufi;cIleeP ti F <br /> rP by the ewer this re eri�,tr. �tfctt,t the 6mr6 trr hick at;Fif flcr+s lrt?Vp; <br /> City of Everest Cffciel Use Only <br /> ow. s1.411, Ua .. , o:,x , PER IT • <br /> erfAulhor€ ed Age Slgnatura < r - t L� D <br /> (J' Cate ` <br /> (Revised S/2,3/2016) <br />