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I IIIPERMIT APPLICATI� <br /> El <br /> BUILDINAECHANICAL/PLUMBING I SIGf +I JRINKLER/DEMOLITION <br /> E V E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 f FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink fl i livi#t ase '. . . . PR©j00.'SITE;fNF 0 &A4hQN_. .. - _ + <br /> PROJECT SITE ADDRESSW-I1(J jj A;/] 1".49- 77(-- if/e, PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> :; ;CONTACT INFORMATION <br /> OWNER NAME: TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 6 5'45 irk rear) Rd <br /> CITY E i ere 1 t STATE (il)ti ZIP C7 5QZ)3 <br /> OWNER PHONE 4 2.5 -3 55_ 01 4 2 OWNER EMAIL: <br /> CONTRACTOR NAME: Paolo Me)o - /\rd ' f k 6 e. 'SAA <br /> CONTRACTOR.ADDRESS: STREET 7 6)12 4 Ever Of reer k/ay 5 311 <br /> /, <br /> CITY Eve re,41- `J STATE �ii ZIP q g `J0`� <br /> CONTRACTOR PHONE: g Z 5 - 355-6543 CONTRACTOR EMAIL: eWere/lire 0'0Scfeh( n r(,�ef�Y <br /> CONTRACTOR LICENSE#(REQUIRED): Y E CJ 821 L.3 CITY OF EVERETT BUSINESS LICENSE NREQ RED): G04 2 L 5q 2 <br /> PRIMARY CONTACT: D OWNER 'CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4Z5 - 355 - 63 43 j L <br /> Pads() Meip CONTACT EMAIL: eve,reH pi rears d .S'C7 j2Fy t�hd tmi,CcM <br /> . ; . . . -.-as- <br /> ... _ .- , , . 'BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$ S 2 . goo , co .. <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU DMulti-Family-#Units: 51Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel DRepair OT.I. ❑Sign OSprinkler ❑Demolition I 'Change of Use <br /> DESCRIPTION OF WORK: <br /> ler' oval cmadisi„scl of) exrsf-,n3 ?r're Suppression sys�-r crud <br /> ' <br /> l n s }-q f i c h.ori c' A heu f1 re s up press)O( Sys 4° meet U L 3,W Canch <br /> ASSOCIATED BUILDING PERMIT#(if applicable): once. <br /> `, 'NEECI ANIGAL PERMIT APPLIATiON. - - >'LUMBMNGr PER11 iIt APPLi0ATiON m =' <br /> Fixture I <br /> List of Fixtures Fhrture List of Fixtures Fixture List of Fixtures Fixture List of Fixtures <br /> Count Count Count Count <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,tioor) <br /> Clothes Dryer Heat Pump&Ductless 'Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> aust Hood(Type i) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other. Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER I.SPS,...-:::, . ON SYSTTEM, Sewage Ejector or Sump Pump Other. <br /> prppres onSyem No.of Heads <br /> Chemica ppression System No.of Beads. <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and coned.Work done pursuant to this permit must comply with <br /> current federal - . .:nd local!= The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the . <br /> Building• ial before being.• ••4.ed under any circumstance.lam the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and I corn:i wit he State Cont•.e :w 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> w HAuthorized Agent natu X - <br /> Date (Revised 4/1520?9) <br /> \ 05--7,- / <br /> 1/4„, <br />