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PERMIT APPLICATION! <br /> BUILDIN1 MECHANICAL I PLUMBING / SIGH DRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: ,5 a vt;\ F Ve-c'c rya, /4)„,/ 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 NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> COY STATE ZIP <br /> OWNER PHONE; L OWNER EMAIL: <br /> CONTRACTOR NAME: rA,IS rife I�rpfe4llri t5y,7 ems Ine. <br /> CONTRACTOR ADDRESS: STREET�piT) 'go( )1(12 <br /> crrY I l i"r itC, fetik STATE Ogi ZIP 9 8,1 <br /> CONTRACTOR PHONE:i,,z6-,38d-QIdN/yaS-3y.---t'ttm`"i''CONTRACTOR EMAIL: Diu/t �barl\Sflire .e.0111 <br /> CONTRACTOR LICENSE#(REQUIRED): R ptsLL earl nh CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): )i6(o D <br /> PRIMARY CONTACT: 0 OWNER El-CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: gran :Smtfh CONTACT PHONE: IiAtb-3LIs-qu <br /> CONTACT EMAIL: bion ( batiltiFire C C1 <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: j'e;tatt Contract Price of Work: $/1i 5;�L <br /> Proposed Use of Building: rt✓iG7li Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair (DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: :14,uve G )Iwy PF II17 19c4,4,01- aP;iiiY)el' hi.u.l,ly L(11‘) ft1e 11dj0t SPhe-ilty <br /> uP i0 sp,InKlers For proper Loveraoe. Auld SPr;r)defs Por- (t?s}rocts,hrtIwiy Lbreakoh • ?•emovt/replace, acC°6r4v55 reds <br /> •f cit test. C'cr 50 yr'; r LQ <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New ?C 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 /> Chemical or Water I .j 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 />