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am • • <br />In PERMIT APPLICATION <br />BUILDING I MECHANICAL I PLUMBING / SIGN I SPRINKLER / DEMOLITION <br />EVERETT <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 I (E) everetteps@everettwa.gov I wmv.everettwa.gov/permits <br />MLe ar 8!12cti,lnkz qni I�Itea t <br />PROJECT SITE ADDRESS:i::C' € ' PFtOP1=RTY TAX #: <br />LEGAL for new construction: Short Plattsubdivision <br />Loi No. (attach copy of tong legal description) <br />OWNER NAME: TENANT BUSINESS NAME (Commercial) i <br />OWNER MAILING ADDRESS: sTRsET 6 t - L �'(_�.y: if ft7' JLA <br />��r.' <br />CITY fir! STATE i.,l/ 3 ZIP <br />OWNER PHONE <br />OWNER EMAIL: <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: STREET /1 (,>% 1- <br />CITY <br />STATE j,,{.,1ft' zIP <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: f <br />CONTRACTOR LICENSE ##(REQUIRED). ( E9 f : ; p.% } CITY OF EVEREI T BUSINESS LICENSE 1f(RE(dUIRED}.' <br />PRIMARY CONTACT: 13 OWNER ©ICONTRACTOR Ci OTHER (Please Specify) ' <br />S <br />CONTACT NAME: CONTACT PHONE: <br />CONTACT EMAIL: lik::ts y <br />Y. 1 t, (.Il f•. <br />�1�9l�iNi3;1>1]F®�i1�47'I®N <br />xisting Use of Building: Contract Price of Work: <br />Proposed Use of Buildin Heat Source: ©Gas ❑Electric ©Other <br />BUILDING USE: MFR ❑Townhouse ❑Dupiex ❑ADU ©Multi -Family - # Units: IDCommercial OAecessory Structure <br />Type of Project: ❑New DAddillon ❑Remodel ORepair ❑TI. DESCRIPTION OF WORK: CJSign 05 rinkler ©Demolition L7Change of Use <br />rr !t"ti /t �f �'� I�r-7.. .{� �Ii ...C� l%%7i,Y <br />> 4.a`':7ij) <br />.ASSOCIATED BUILDING PERMIT # (if a plicable): <br />_ ( � / � { , <br />- -- <br />MI <br />�� »ICAL RIV <br />- <br />a ���a <br />: . <br />Fixture <br />Count <br />List of Fixtures <br />FtxturO Fixture <br />count List of Fixtures List of Fixtures Fixture <br />A/C—Alrl-fandting Unlls <br />Count fst of Fixtures <br />Gas Pi in Count <br />A 9 <br />Salter <br />Backf(ow Preventer (inside Bldg) Shower,, or Combo <br />Clothes Dryer <br />Gas Ronne Cloth's Washer ' Sink-Corcial (3-eomp,p---floor) <br />i <br />•r <br />Heat Pump&Ductless Dishwasher Sink-Rentlal (Bitchan,bath,bar} <br />Refrigeration Drinking Fountain <br />Duct System (Remodel) <br />Exhaust Fares (Restdantlal} <br />Commercial Ventilatio Floor Drain Slnk-Utilaund , mop <br />Heai/AC s stem) Hose Bibb <br />Water Heater Interceptor -Grease Piping Repair <br />t% <br />Exhaust Hood (Ty e 1) <br />Exhaust Hood (T a Iq <br />Exhaust Hood (Residenllaq <br />Air Systems <br />%Toilet(Nol <br />Wood Stove interceptor-Sand/011orced <br />Other. e(behindMedical <br />Gas Fireplace/Insert/Log <br />Gas or Fixtures <br />SIPiaBPNii4iLEJ;l& <br />" �$9P"OSKIDN <br />Roof Drains <br />Stfiltt:iM <br />.i c. ...........,.., <br />n. .. <br />., Sevrage Ejector or Sumo Pumn nih— <br />.. <br />hto, of Heads I--. <br />ACKNOWLEDGEMENr.' 1 have revfetmd this application and cnnfrrrn the tnformalion contained herein is true and correct Work done pursuant to this parmii roust comply tnth <br />current federal, stale, and local to v. The granting of a psrmft only authorizeS approved work and no deviations therefrom. Davieflons must first be authorized in writing from the <br />BuNding ONfcla or��eTng auyi ie underany circumstance. / am the owner, or t am authorized by the ownarof this property to perlenn the v✓ark for4ahieh application Is made, <br />and i comply i ' h t Stata Conlractor aw 18,27 RCW and 206,200A WAC. <br />City of Everett {lfflcfet Use Only <br />port uthor zed Agent Slgnatur Date (RavisedY4llri/2D19) _ — <br />1 l <br />X2— / <br />