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4rEn" PERMIT APPLICATIOI I <br /> BUILDINC-�CHANICAL/ PLUMBING /SIGN'I WINKLER/ 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 /> PROJECT SITE;INFORMATION_„ _ _, , = <br /> PROJECT SITE ADDRESS:z.tJ l(r_7 elitilp , ' PROPERTY TAX#: <br /> N <br /> LEGAL for new construction: Short Plat/subdivision 6(Pi vC.tie/ I f s Lot No.3'' (attach copy of long legal description) <br /> T '' CONTACT INFORMATION <br /> OWNER NAME: #1,p/4 .. / e.j9ALS LL _ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /e)D 514) ' .tl ere..* AS L# /5,,/Ltit2 <br /> )0° �j �y <br /> CITY £.0 (la STATE at ZIP Z v c -o <br /> ie <br /> OWNER PHONE: ` 5q53-- bO OWNER EMAIL: W 14.)W. SeApcsft-Ifiekne S 4 C:-€.)N1 <br /> CONTRACTOR NAME: 5€4 Pc,c_ t4V N?P_'S <br /> CONTRACTOR ADDRESS: STREET % O S Lc) E U ere# itlic,/t � - ! � <br /> CITY LE jjer .1 f STATE (sof p ZIP 7 It y <br /> CONTRACTOR PHONE: L/XS- 953 v �0C CONTRACTOR EMAIL: L1/14" . cc, �C.,,,ho04 tss . C_css?1, <br /> CONTRACTOR LICENSE#(REQUIRED):5,4 PA` ii-5(s � 7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):I 5 339 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR .QTHER(Please Specify) Pr Oi -f a4dr1 a,C <br /> CONTACT NAME: '9 CONTACT PHONE: I 5- 315 cD Li 3D <br /> (14 i4yRo&eiJoac L CONTACT EMAIL: bio r- ID fi eA o ,per e.S cairn <br /> CONTRACT PRICE OF WORK <br /> -BUILDING PERM <br /> Existing Use of Building: HEAT SOURCE: <br /> Proposed Use of Building: ❑Gas tgglectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: LI Commercial ❑Industrial <br /> Type of Project: 'Mew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> 0/cnn 9 'f 2-4135 <br /> MECHANICAL;PERMIT APPLICATION PLUMBING.PERMIT'APPLICATION , <br /> Type of Project: X_New — Addn Alteration _Repair Type of Project: KNew _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump 7 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater / •Bathtub Urinal <br /> Gas Piping Boiler 5 Lavatory(Wash Basin) Drinking Fountain <br /> f Water Heater Refrigeration ,Shower Floor Drain <br /> Gas Fireplace Wood Stove j Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting / Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: / Clothes Washer Medical Gas <br /> Range Hood �'ji Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER%SUPPRESSION SYSTEM ', <br /> Number of Heads <br /> ACKNOWLEDGEMENT.•1 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 i a,e, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only 2) <br /> PERMIT# <br /> - -fie_ l — i 5 -16 G lci 1 -63°3 <br /> Owner/Authorized Aaent Sianature Date (Revised 10/12/2015) <br />