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11161111 PERMIT APPLICATI .... <br /> .BUILD I MECHANICAL/ PLUMBING I SIG SPRINKLER / DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> wAswNGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everctieps@everettwa.gov I wvvtrverettwa,gov.'perrmts <br /> (Blue or Black Ink Only Please) - PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: c} PROPERTY TAX#: <br /> LEGAL for new construction. Short Platfsubdkvision e - �r _ _ _Lot No (attach___�. copy of long!side;rSt?srrrrar�-ar-o <br /> CONTACT INFORMATION <br /> TENANT BUSINESS NAME(Commercial); <br /> OWNER NAME: l a ` _ „ .,- <br /> OWNER MAILING ADDRESS: s r, ''F'"'' <br /> Gam.. L <br /> . <br /> OWNER PHONE: . <br /> 0, OWNER Ei4+9AfI«, re. , 41, ,+' j 0 <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> ciTY <br /> CONTRACTOR PHONE: <br /> CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#` ion.OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARYCONTACT: NERD);tR <br /> CONTRACTOR 0 OTHER(Please Specify) } <br /> CONTACT NAME: CONTACT PHONE: (fib) 5 ! -aL5 Cl <br /> 0\0e. ,f- _s--i i l ,-IA 0 CONTACT EMAIL: ) <br /> BUILDING INFORMATION <br /> ' \A cz 0 <br /> Existing Use of Building' Contract Price of Work:$-� � � . � ''" <br /> Proposed Use of Building (Y6as •• lectnc $other <br /> - t,�� ;.�,dl�i- e wy j I{°�- b�arra�" Heat Source: o�� <br /> BUILDING USE I FR z .(Townhouse �puplex L1ADU [MA-Family #Units. eStructure <br /> Y QCammerciaE �Ac wsscry <br /> Type of Project: UNew DAddition emodel L,iRepair OT.I. C Sign USprink$er UDemotition ❑Change of Use <br /> DESCRIPTION OF V+iK: � jt ` ' <br /> �-c I S -.- I .. t C.� 3 <br /> ASSOCIATED BUILDING PERMIT#(if appticabie):. .- L)v`t I 4/ -1 �l LC'�I 11-- t 1/1-i'f-.c p-/' --i 2 .3' <br /> MECHANICAL PERMIT APPLICATION <br /> PLUMBING PERMIT APPLICATItiN <br /> Zxtuto r=s'R�z+r� FixtureCnunt List of Fixtures List of Fixtures List of Fixtures Fixture <br /> Cowl _ Count Count List of Fixtures <br /> NC-far(-$as r}!€r'rp Units Gas Pip rip Backflow Preventer(Inside Bldg( Shower,Tub,or Combo <br /> F'oaior Gas Range Clothes Washer <br /> Clothes Dryt.f Sink-Commorcial d.-cramacirep,ftocr,t <br /> Heat tamp&Ductless Dishwasher _ Sunk-Resirrentat(kitchen,bath bar) <br /> Durk System{R in e a rf � ratuan Drinking Fountain Sark-Ursity,laundry.mop <br /> Exhaust Fans(Residefi,Jali Cornrrerral Verrt,-latior'v Floor Drain Toilet <br /> (Not HHcotltC system) Hose Bibb Urinal. Exhaust Hood(Ty6 It, � Water Heater interceptor-Gretaso WastetWater Piping Repas <br /> t ✓. (R.es eritaa i W St.ie Interceptor-Sand?Oil Water Services <br /> «. ht hin l ne fit' <br /> f` Aar6f rrrr 'Other L. tvtedivalGas n r _ <br /> Wake?Valves f ttrr a <br /> as FK*04f,xlinsefttLog Roof Drains <br /> PRIt�Ikt.BR:(SUPPRESSION STEM .._ m e surge Elector or Sorel)PumpOther <br /> Heater <br /> r <br /> b R 5m <br /> :W �,,:* <br /> f <br /> a <br /> �.7I ; � ��I ,° �eattora and-confirm the information contained herein is true arid correct Work done pursuant to this permit must numbly with <br /> #01 ' c 1. i re. ofisprmit Only authortte,s approved work and no deviations therefrom Deviations must first be author/zed in writing from the <br /> �fr sttkn t em the O-mar,at f am author/cod by the°mini of this property to perform tim work for av°hich appl. alien is made, <br /> 4f l t. t m :t C" and 29V 2 A ill; <br /> y,�y x .''; City of Everett Official Use Orgy <br /> y <br /> p v pEr.LLAer L. <br /> rI �4. ,T a 2, Dater (Rovtsed Ion0127iB) <br /> ... 53� x 3n� r?Y' ,.;- fix. ..... '' ,r 1G..�J <br />