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• <br /> PERMIT APPLICATION• <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> E 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:Z �/E S (. J-'A PROPERTY TAX#: .L 8 a 4 13 O D ( 61400 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 6mEo4LD 8LUY.CS LLC TENANT NAME(If Commercial): - I f Q B CLI-Ar.S <br /> OWNER MAILING ADDRESS: STREET GV/E(Z t.1✓,, cA-f.t (Jo fed A 7 p.�,y <br /> cITY ` ' STATE A ZIP o za4 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: /3 CLFO2 Pao PE fl R Esrv•c/kT'Or <br /> CONTRACTOR ADDRESS: STREET 1-432c-) Soote_ (3t sr p L . S'`--€ I0C5 9 �y <br /> CITY 5Q GNv_)' `B ' STATE ZIP 6 V 4 e <br /> CONTRACTOR PHONE: ZO 4s - to 3 2 -O8 O O CONTRACTOR EMAIL: J Q T F.fe9• L e.G6 e v S.6,2.teen.•ed. <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQ IRED): <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2,_ vG - Co 4 I - I E" 5P <br /> J.-C- A,i D '(-°' 6r6 CONTACT EMAIL: ,J Q -fLy , LCkc Q us .6.e( , ,. <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ <br /> Proposed Use of Building: Heat Source: ❑Gas El Electric DOther <br /> Building Type: DSFR-Detached DSFR-Attached ❑Duplex DMulti-Family-#of Units: DCommercial ❑Industrial <br /> Type of Project: DNew DAddition DRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> Yr-c_ FIce .TNsee c-ha <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 /> A/C—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 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 /> Number of Heads I <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 /> .p City of Everett Official Use Only <br /> ' �' �yY''IC PERMIT !� I- oo uOwner/A thoWes ' .tip ignat�,/ Date (Revised 10/12/2015)1/ <br />