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PERMIT APPLICATION <br /> 41111111P <br /> BUILDING MECHANICAL I PLUMBING SIGN 1 SPRINKLER1 DEMOLITION <br /> ,41:tifilia CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 518201 <br /> (P)425-257-8810 i FAX 425-257-8857 j(E)invereiteps@averettwa.gov 1 www everettwa; ovi errnits <br /> PROJECT sure INFORMATION <br /> PROJECT SITE ADDRESS: a 'ROPERTY T. # <br /> F <br /> LEGAL for new coristnictiorr Short PIatsubdivislars Jot No._ (attach copy&ittong tapal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: cre,A Mel4e, TENANT NAME(if Commercial): r t t i t Cry <br /> OWNER MAILING ADDRESS: STREET 11+f% &Az_ g <br /> CiTV yy STATE L.FNsr.. Lary 9-7z.62- <br /> OWNER <br /> "7z.6OWNER PHONE:503 232."" likati 4 OWNER EMAIL: <br /> CONTRACTOR NAME: f"jic.. as <'- <br /> CONTRACTOR ADDRESS: STREET it <br /> CITY C5 __... -.. STATE EP 47-7030 , <br /> CONTRACTOR PHONE: D, ; o ._ ',i CONTRACTOR EMAIL: f fie resCtatlc •.- <br /> CONTRACTOR LICENSE REQUtREU$, . ' ' rsITY OF EVERETT tatiSINESS LICE E#°.Qitt4 D) ",Air_ .,. x <br /> PRIMARY CONTACT. 0 OWNER ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: "0 <br /> CONTACT PHONE: ► ; , ► <br /> 8,1%1 P.D9e47i CONTACT EMAIL: bit t _._,:. cavl <br /> BUILDING PERMIT APPLICATIO, <br /> Existing Use of Building: Contract Price , Work:$ -. ;dal. s 00 <br /> Proposed Use of Building: Heat Source: Pkaaa DEactric DOther <br /> Building Type: OBER-Detached OBER-Attached DDuplex Df iuiti-Ferniiy. • Units: SDC •>- 'Idol DIndustrial <br /> Type of Project: 0New KILkidition ®Remodel DRepair Oil. °Sign I rprick r "Ele lilitio, L'_- •e of Use <br /> DESCRIPTION OF WORK: 41440A ,i gb c_C + Vak !""*04r• rile,k t` ,— <br /> c <br /> II ` . ,' <br /> g <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING -.. „ • •LICATION <br /> Type of Project: New. Addis ye,ikiteration Repair Type of Project: _New Addis Alteration ,,....,.,,Repair <br /> #of #of #of - #of <br /> List of Fixtures List of Fixtures List of Fixtures fist of Fixtures <br /> Fixtures Fixtures fixtures Fixtures <br /> C—Air Handling Units Heat Pomo Toilet _ _SackhowPrecentor(inside-Bldg) <br /> Forced Air Systems Unit Fea rBathtub Urinal <br /> Gas Pipin• Boiler Lavatory(Wash Basin) DrinkinE 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 /> rClothes Dryer Hookups• Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fart Sink( et-vice!Bar/Moptetc.) Other <br /> SPRINKLER if SUPPRESSION SYSTEM <br /> ]Number of Heads <br /> ACKND WLt"DGEMi N'I`I have reviewed this application and confirm the information contained herein is true and correct Work demo pursuant tom permit roust comply with <br /> current federal,stale,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 authcrr`ied-under any circumstenae.tent tire owner,or t am authorized by the owner of this'properfy to performins work for which appiketion is made, <br /> and I comply with the State Contractors Law-I fl 27 ROW and 2952004 WALl <br /> City of EverettttjOff/fii��cial Use Only PERMl`CVIA i] V Oio <br /> Own Drize Agent Sig taro to (Revised 1 /t2'2015) <br />