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• PERMIT APPLICATION. BUILDING / MECHANICAL/ PLUMBING / SIGN /SPRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: } J 2) )(Wyk_ S p (,)I/ PROPERTY TAX#: C)C bV JC ( C�C L1 0 J C ) LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Ncr c , vV, TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET '7 iS Mc,.pf e I- CITY Ev6'. f f- STATE IN{ ZIP 9 e OWNER PHONE: J OWNER EMAIL: CONTRACTOR NAME: 5'f-a.-�� t , / S 'J-(j rah' c CONTRACTOR ADDRESS: STREET �/3 1{5 0 U ((77 CITY i V V Ui) 6 i�✓; ( 1 C . t STATE AM ZIP 9� -O I CONTRACTOR PHONE: LI Z S -D_9-LI 0 S D�9�`/CONTi LRACTOR EMAIL: ��1t✓h . ��o (d€r 9L�S IK� -e l.(JI�Ie :l�'1 CONTRACTOR LICENSE#(REQUIRED): S I a'IE�i Z�b& K 14 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 15 5?.7\ PRIMARY CONTACT: DOWNER CONTRACTOR aOTHER(Please Specify) Fe). tt2S;fiel P Ieci,)L C-Q(( /4/d1 L.— CONTACT NAME: tb'-E`41 0-1-i5 rqr 11.1 CONTACT PHONE: Z5-_ 7 - 7 Far .tsrn,.c.✓Ltr✓\GvrtCpli�S rtt <e aat; Co,.f4c'dD, `� '+:` �RgirtzL i�cj �Sf DES rieaseco,t ( CONTACT EMAIL: bc„,,,l b�, reA-r-SlE cif t.i& ( ' C C /t) Nr`t tk-t;1 ll S Is!'c:l SGILA:k f u.4 S. BUILDING INFORMATION Existing Use of Building: 5 t'f` Contract Price of Work:$ (�L'/ - c) Proposed Use of Building: ) F Q Heat Source: ❑Gas .RElectric ❑Other BUILDING USE: ®.SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel .Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: n��a r ��r - r dome_ .�.v -y f C � ctt �t,se {->''-ss deslg nic e4(.v�2oof-System . � � `F ASSOCIATED BUILDING PERMIT#(if applicable): Mig41416 MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixtur Fixture Count List of Fixtures count List of Fixtures C nt List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or C o Boiler Gas Range Clothes Washer Sink-Comm (3-comp,prep,floor) Clothes Dryer Heat P p&Ductless Dishwasher Sink- Idential(kitchen,bath,bar) Duct System(Remodel) rigeration Drinking Fountain • -Utility,laundry,mop _Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Resi tial) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Syste s Other: Medical Gas Water Valves or Fixtures Gas Firepla nsert/Log Roof Drain Water Heater SPRIN ER/SUPPRESSION SYSTEM Sew e Ejector or Sump Pump Other: Water Suppre on System INo.of Heads Chemical ppression System INo.of Heads 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official UseOnly PER � d Owner/A thorized Agent Signatr e / /Date rpj) (Revised 10/10/2018)