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����i� �a���.i���ic�� <br />" __ �3lJl[n.C�i� i1��CH,��ICA� / W�lJt1li�I�IG / S1C3���I�K�.ER / DEi�lIOLIiION <br />CITY OF EVERETT PERMIT SER � <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@evereftwa.gov � www.everettwa.gov/permits <br />OWNER NAME: �� � � <br />OWNER MAILING ADDRESS <br />OWNER PHONE: � C C — <br />-�c:c <br />STREET <br />CITY � <br />��i-Z <br />CON7'�►C`Y 9NL���Ni�►'H"IOP�9 _ <br />-��,-,�: �� S TEPJAfVT NAME (If Commercial): S s r•-, � <br />- -- / � � � j' l , �. �= . <br />�^ C. <br />G' �'� �OWIdER EMAIL: <br />STATE (i( . � �7� ZIP C"J ��, G <br />CONTRACTOR NAME; .`S �� � �� , � � l ��t �� <br />CONTRACTORADDRESS: sTReer G� —��/� �� �t C,' C �L11�- <br />CITY � � -d ; � / � I � STATE �J �7� ZIP � g � � �. <br />CONTRACTOR PHONE: L 6 � Z� S �S `J3-� �_S CONTRACTOR EMAIL: ��'� _�' }�c, �C, .r� � �v��P"� . �li C <br />CONTRACTOR LICENSE #(REQUIRED); �.. S� �L l i� J� —S 7 CITY OF EVERETT SUSINESS LICENSE #(REQUIRED): �' <br />, ._.,�.....:. .._ .,.-_ ,- ..._._., �.:__.::. ,-__. _... .::_..,.._ .. _..� _.,.__ .�.._ . ._.. �_;. ....._. _-� ....... . ._..... . __... .... .. _ _�. _._ _........ __ _..,, ..... ,. , . .. <br />PRIMARY CONTACT: ❑ OWNER I�CONTRACTOR ❑ OTHER (Please Specify) <br />'CONTACT NAME: CONTACT PHONE: � Gl — Z, f � �„ � � �S <br />/ /'�S � / CONTACT EMAIL: %� ��� / • , ,f�"4 ,� /r Tc,c�tCi:, l=% <br />` BUILDING PERMIT APPLICATION <br />Existing Use of Building: Contract Price of Work: $�1:� � .� <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Aftached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: � Z, � �. �� y �,�.5 -J��� � c� G� L,% e �? �rt?C'.1/�. ��C � / �` / ,tj�i I�yLll /�j� <br />TED BUILDING PERMIT # (if appli <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _ Addn _Alteration _Repair <br />Fiaiu es List of Fixtures Fixtures List of Fixtares <br />A/C —Air Handling Units Heat Pump <br />Forced Air Systems Unit Heater <br />Gas Piping Boiler <br />Water Heater Refrigeration <br />Gas Fireplace Wood Sfove <br />Gas Range Ducting <br />Clothes Dryer Hookups Other: <br />Range Hood <br />Exhaust Fan <br />SPRiPdKL�R / SU.E�PEZ�SSIO6d SYS7'EM <br />Number of Heads <br />PWMBING PERMIT APPLICATION <br />Type of Project; _New _Addn _Alteration _Repair <br />Fixfures �-�sf af Fixfures Fixtures List of Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <br />Bathtub Urinal <br />Lavafory (Wash Basin) Drinking Fountain <br />Shower F�oor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roofi Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/etc.) Other: <br />ACKNOWLEDGEMENT� l have reviewed this applrcation and confi�m the information contained herein is true and correct. Work done pursuant to this permit musf comply with <br />currenf federai, state, and local law. The gran6ng of a permif only authorizes approved work and no deviations fherefiom. Deviations musi first 6e authonzed in wrrting from the <br />Building Offrciaf 6efore being authorized under any circumsiance. I am the owner, or I am authorized by the owner of this property to perf�rm the work for which application is made, <br />and / comply with fhe State Contractors Law 98.27 RCW and 296.200A WAC_ <br />City of Everett O�cial Use Only <br />PERMIT # � <br />� � � � ��� � � �'�?, <br />Owner/Authorized Ayent Siynaiu Date (Revised 5/20/ 09 ) <br />