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• <br /> PERMIT APPLICATION <br /> BUILDING i MECHANICAL I PLUMBING I SIGN I SPRINKLER I DEMOLITION • <br /> *4r."7CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits , <br /> (1044"®i.Black Info®nty.!(ease) • i • PR^JECT IT iNFORMATIO> • <br /> PROJECT SITE ADDRESS: 7470 6/A7 PROPERTY TAX#: 0054,2T56/D2-540 <br /> LEGAL for new construction: Short Plat/subdivision / Lot No. (attach copy of long legal description) <br /> -/ L .CO 1TACe'INFORMATION . •_ . • • <br /> • <br /> OWNER NAME: WZ,/� �F(/e2G�6lei 71 .7 <br /> TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: smear ZjZ.4-2.--0 ea(47 • <br /> CITY Vat I` STATE 441A ZIP 9; _s <br /> OWNER PHONE: g7S-3 tt1��1- 3 O 7 OWNER EMAIL: A//pi4f'f(4'67 J4 o.cam <br /> CONTRACTOR NAME;., �.,.E. 0-.Y�.Ca�-- ..,...6"r rT(( E MGT-Arc CONTRACTOR ADDRESS: STREET .12 O CSL pt.- AU er • <br /> cnY k a U STATE f) 4- ZIP (r Z7 2o/ <br /> CONTRACTOR PHONE: 4`2-5.2- 2.-'5/iq • CONTRACTOR EMAIL: /VA/0"& <br /> CONTRACTOR LICENSE#(REQUIRED): C()6124655 e 2.2 o rCll Y OF EVERETT BUSINESS LICENSE#(REQUIRED): i2 6-7 , 3 • <br /> 5 <br /> PRIMARY CONTACT: 0 OWNER RCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT N E: CONTACT PHONE: 4 7 s---X5"2.d,//9 <br /> Mill414 11 <br /> CONTACT EMAIL: Mt*@4. <br /> •• . ' <br /> BUILDING PERMIT APPl!KATION • • • • • . <br /> Existing Use of Building: OFF7LE -11(0 6/0ult" Contract Price of Work:$ Z9.OPO <br /> Pro <br /> posed Use of Buildin : OP(C( - N D et 6 Heat Source:Family# C�Gits:as DElectric ❑Other <br /> p g <br /> Building Type: ❑SFR Detached [7SFR Attached • ❑Duplex OMof UnffiCommercial ❑industrial <br /> Type of Project: ❑New DAddition ❑Remodel Repair CIT.I. ❑Sign ❑Sprinkler ❑Demolition C(Change of Use <br /> DESCRIPTION OF WORK: R��o,,g 1461 2 5_to„ 5$m- 4.01€. -y w/GIA-s t 0,4r , &GO ..vwt)�je{c . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> IV1 CHANJCAL,PERMVMIT A.OPLICATION . . • . PLUMBING 0.00/1I14 APPLICATION • • <br /> Type of Project: New Addn Alteration IL Repair 1 Type of Project: New Addn Alteration Repair <br /> #of List of Fixtures d of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> AIG-Air Handling Units ' Z 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 HeaterR• efrigeration Shower _ Floor Drain <br /> Gas Fireplace _ Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher 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 /> . ORI IKILER/,O.PPREP I©N SYSTBIW I ' <br /> [Number 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!am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> I <br /> PERMIT m04,_05. <br /> ..... <br /> -uw,ne/Authori Agent Signature /Z// 9 Date` (Revised 5/�20//20I15) <br />