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PERMIT APPLICATIONS <br /> ,%/ BUILDING I MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> (BJlu a rslr.Btack lists Eyrrtly,Phase ; , ., PROJ.r=CT t, E fNFORMATION. <br /> PROJECT SITE ADDRESS: esiq 4r Wig qo PROPERTY TAX#: (7057 8 `LOGO DO goo <br /> LEGAL for new construction: Short Plat/subdivision 6 ' ' of No. (attach copy of brig legal description) <br /> -00TACT;INFORMATLON <br /> OWNER NAME: �.1 t7'jGf� �i Z- mac) TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET y0 2,5— vz.I7_69' -E %iJ w-pV WA- <br /> �-j� <br /> CITY // / STATE A 7 / ZIP q8 ' <br /> OWNER PHONE: '7 2 23 9"- ? O OWNER EMAIL: Jed 9 g 'f G yahoo 70 'efe a2 <br /> CONTRACTOR NAME: ®GUk,A p if i) g <br /> CONTRACTOR ADDRESS: STREET '` <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR XOTHER(Please Specify) �'' v��' ,5 • / 6 % om/ <br /> CONTACT NAME: CONTACT PHONE: 05 Zq ` 95--q&`- Y CONTACT EMAIL: _90-31-, <br /> / 9S 2_o41Ccs yrhooeCOM <br /> Existing Use of Building: Contract Price of Work:$ ' C°1) <br /> Proposed Use of Building: Heat Source: OGas ❑Electric ❑Other _ <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial _ <br /> Type of Project: ONew Addition ❑Remodel GI Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> "1-i- pea 1 acee s lode emftylia Ail 6y galati:c. y4 s '7o 64 to �il/s�¢l j a e scri-7 <br /> ®psrcf/resr. en c;Ise. AReer r�ecieg. /' cr'deck add aur '60(-� p <br /> 6 +a QI9 06°' N: c,-e" <br /> 5e.w'f- (-IOs/Mg$ WITA/Lance CTdP70607ToM) <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 /> Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures <br /> NC—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 /> .. ;<-'SRRINKL,�R<)SOP1',RESS�ON 5'1fS't'EM` , <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 before being authorized under any circumstance.I am the owner,or 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 /> 9� E /D -. - 17 <br /> nen/ thorized Agent Sin re Date (Revised 9/23/20W) _ ) <br /> ?DvSK- 02s.o ,� <br />