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IIII''II 51( aIi <br /> /11**4000/71BUILDING /MECHANICAL/PLUMBING /SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> %��� PERMIT APPLICATIC�V <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 /> (Buse or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3 3[ Seam y 5-2)1 et j3Lf A PROPERTY TAX#:2 gO 4'0'/60300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No.1 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:"DC.('-tC.tt‘ Cdkp i -1c.,1 .-- ,,,e4 N cr s TENANT BUSINESS NAME(Commercial): 1 GC`r -POW et- <br /> OWNER <br /> rOWNER MAILING ADDRESS: STREET 5.1g/0 /60h Akre. A.) <br /> CITY ,MCOMA t , d STATE / {) ZIP C7$6 <br /> OWNER PHONE: 925- 2 7S OWNER EMAIL: <br /> CONTRACTOR NAME CO peer 1 R t b i" ij )tic e$ <br /> CONTRACTOR ADDRESS: 1 USTREET /9/13 / <5A Otic. <br /> Kr iC`(4' rJ (I CITY STATE (41J zip 9g03 ' <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: Ok ,�/ <br /> CONTRACTOR LICENSE#(REQUIRED): Ca PP ECp $79 O'.i CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1V <br /> PRIMARY CONTACT: ❑OWNER egtC.ONTRACTOR ❑OTHER(Please Specify) athj chrN/ Con)4.fccc,1.0.....- <br /> CONTACT NAME: CONTACT PHONE: 925--- 3 9 -/0 F <br /> Jcvf\`'l1I1-e(` CONTACT EMAIL: apppercf Cc.ertAgi I - cOhA <br /> BUILDING INFORMATION I <br /> Existing Use of Building: M�(, ) Contract Price of Work:$ de/e. 000 e'e' <br /> Proposed Use of Building: 1 _ Heat Source: ❑Gas DElectric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse El Duplex DADU ❑Multi-Family-#Units: OCommercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition A4sFiemodel ❑Repair ❑T.I. El Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: (/�/� ( _- 1 1 1 <br /> ' t-AV"-'00r i l i / lC ‹.-SS (`t30 i\A 1 S kv c.r-ZC.,S GZ-yv cl, 1�r��. t. C'00 __ c S <br /> t <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> FixtureFixture Fixture Fixture <br /> List of Fixtures • <br /> count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) ,2._ Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer f Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher ? Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration a Drinking Fountain /e5- Sinit-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilator Floor Drain /0 Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) ` Hose Bibb A 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/SUPPRESSION SYSTEM _ f Sewage Ejector or Sump Pump Other: <br /> Chemical or Water I 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 bef. - .- .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 <br /> made,and I , ply with e Contracto r aw 18.27 RCW and 298.200A WAC. <br /> ACity of Everett Official Use Only <br /> Ai <br /> rr <br /> op..-.40111111 10 p <br /> PERMIT# <br /> -. //—/Z45 'il Foor -ota <br /> O .t:r-•" ut,orize• •gent' jr re Date (Revised 10/10/2018) <br />