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I <br /> #111°P'.: PERMIT AI I LI jATII N -41 <br /> BUILDING I MECHANICAL/ PLUMBING I SIGN 1 SPRINKLER 1 DEMOLITION <br /> .r`t:'+.rr'..l:+t'"".7 L''''rP..4rrr CF%R.V r1"r• '! <br /> nor r^v <br /> __ _578-.3 i . Ram 25- 8857 . (E• _ <br /> tT-t'fiGJ-G�i-OOiV t Ffi/�4La-L7i-04�t !(C)CVCt CYt813S�t„U,-BV Cit~tt'NCI.yUV I vdfitryv.BverGtiNiB.egCYVPjYLi rPt`tts <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION it <br /> )PROPERTY TAX#: # <br /> 'PROJECT SITE ADDRESs:3214 56th St SW <br /> ILEAL for new construction: Short Plat/sub-division Lot No. (attach cup,of rag legal description) <br /> CONTACT INFORMATION <br /> i <br /> iowN Thomas Sacco TENANT BUSINESS NAME.(Com., ::'-t`i <br /> OWNER MAILING ADDRESS: srn=ersa <br /> t; <br /> CITY STATE ZIP <br /> lowNERs 4253501963 f ti .. : <br /> CONTRACTOR NAME:Tim Hamblen t�►�R,\CEJ l(\S �"'AG I <br /> CONTRACTOR ADDRESS: STREET7409 68th Ave. NE <br /> I <br /> v,n. Marysville t H <br /> WA <br /> STATE <br /> 2.,,, 98270 <br /> COPHONE:425-501-0123 CONTRACTOR EMAIL: <br /> bamb{Bn Sdgat.Corn <br /> fOF FVERFTT Rt1CINFS* ^.F44SE#/RFAtliRFD1• 053666 <br /> i <br /> f. <br /> r.OI+rTRAt'Tf3Ft-i lr FIS fftIC31+1En}kiAM LSH922©E -`rr <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: I <br /> I i <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:S-50° <br /> Proposed Use of Building: jHeat Source: OGas UEleqtric DOtner_ 1 <br /> Rt ill DING USE: FIRER I (Townhouse �.....iDuplex I lADU t I tMfuIti-Farnil y-#Units FiCdilimArcial 1 UAocessory Stricture <br /> Type of Project: LJNew [3Addition DRemodel DRepair DT.I. DSign OSprinkler DD 1olition DChange of Use <br /> DESCRIPTION OF WORK: Extend tias line-10'to support a new Generator.. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION I PLUMBING PERMIT APPLICATION <br /> Ftxtur c FL,wro 1 #fixture ( List of Fixtures 'Fjrtt'rre I Lisa of Fixtures <br /> List of Fixtures Lfst of Fixtures Count <br /> Count Retire Goanf <br /> A/C-Air Handling Units f Gas Piping Backflow Preventer(inside Bldg) Shower,Tub,or Combo <br /> - - e-1.-,(!,..=`r::S::ac "i -'-'.".::".'c:;.ia:£.�::::.-:Y.h`;�Ei, vi:j <br /> I ct ...704::cr;gaI <br /> ICiathes Dryer (Heat PumpBDuctless i (Dishwasher Sink-Residential ikitchen,bath.bari i <br /> trust System(Remodel} !Refrigeration lurinicing Fountain tsink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatio Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> I Exhaust Hanel(Type II) (Water Heater Interceptor-Crease Waste/Water Piping Repair i <br /> Exhaust Hood(Residential) Wood Stove 1interceptor-Sand/Oil lvdater Service(behind meter) <br /> (Forced Air Systems Otho !Medical CGS Water Valves or Fixtures <br /> (Gas FireplaceiinsertlLog i I Roof Drains Water Heater <br /> SYS <br /> I SPRINKLER!SUPPRESSION SYSTEM aTi'csrs � �:�s;tage Cjec:ur or t;�i,�,Pump ^.F,er: g <br /> Water arrpnrese nn System 1 INn.of Heads <br /> Chemical suppression System jive.of Heads i l I <br /> ACKNOWLEDGEMENT:t have reviewed this application and confirm the information contained herein is true and correct.Woo.i done pursuant to this permit must comply with <br /> 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 <br /> Budding Official before helna authorized under any circumstance. I am the owner.or I am authorized by the owner of this prop ty to perform the work for which application la made, <br /> and I campy;lith,thy stats Cort .oro Low le.27 ROW cod 206.200A WAC. <br /> City of Everett Officiat Use Only <br /> `(Z/f/9 11 ..5/05:// <br /> IPMIT <br /> 't VVVvq0 -- OS 41 1 <br /> -owner/Authorized Agent signature Data (RPviCarl tt)If/01}1R) <br /> I <br />