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BUILDINL 1 MECHANICALS/PERMIT <br /> //SIGN INKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: tic OZ. 1ST" ST-Xis4rr 'S1+ ) PROPERTY TAX#: 00111.2 00000 Ico <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 5100144N ISO GLUorY Av3 . ,i. TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 2,:$2.1., C441.I F e ai)144 SWAG .1 <br /> CITY EQ40.411- STATE 1oA ZIP C%(s?„v <br /> OWNER PHONE: I41.S-'Z'S$ +-ZILir OWNER EMAIL: ' G(00,,05@ s...)00,00,C401110, <br /> CONTRACTOR NAME: Isc h.L.C... > V -% C-0CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): N_e. .JA -t•Q- s-- CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):OSeR-fa4 <br /> PRIMARY CONTACT: yOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (42.5 -v3 i _2,1 <br /> O/SJt s , e4_ CONTACT EMAIL: (32,Ci A s 51,,,10 fug) .0 arm <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: OFF'CA- (tj()1(.Y)IAA. Contract Price of Work:$ 10,0010 <br /> Proposed Use of Building: OFF IGS. 001a)vi.C.. Heat Source: ❑Gas DElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: %commercial El Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel %Repair CIT.!. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: ��33 <br /> fLti A -c LII yrl s) v`�12ooF if)444 w s 1'+"11 CAN) I.a <br /> w/ I‘T OV Fc o0OS <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration _Repair Type of Project: _New _Addn _Alteration Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher 'S Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I No.of Heads • <br /> ACKNOWLEDGEMENT.'I have reviewed this application and confirm the information contained herein is true and correct.Work 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 /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Authorizent Signature Pate (Revised 9/23/2016) <br />