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PERMIT APPLICATION <br />IM BU!L DING MeCHAN!CAL / PLUMB!NO / S!O!q /OlNKLER / DEMOLITION <br />EVERETT 32CITY OF EVERETT PERMIT SERVICES <br />00 CEDAR STREET, EVERETT, WA 98201 <br />NASMN(_TON (P) 425-257-8810 1 FAX 425-257-8857 I (E) everettepsneverettwa.gov I %efAnnJ,e�JefP �/.7,�Q+II,nermltS <br />(Blue or Black ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: <br />7 <br />PROPERTY TAX #: ��', r <br />LEGAL for new construction: Short Platisubdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: TENANT BUSINESS NAME (Commercial): ­ ye n,� L, 1 y t -L <br />OWNER MAILING ADDRESS: STREET <br />/2v�' <br />CITY L-v�- . S V e S STATE V G A ZIP <br />OWNER PHONE: _ ULI) <br />— U 4(�o <br />OWNER EMAIL^ OnI j6 S G L' e'l— 1(j v co" <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: STREET Notl��� \,,1�7 N 2� <br />CITY ` STATE �'�' ZIP <br />CONTRACTOR PHONE: q1S'Lj <br />I — 9 1 <br />CONTRACTOR EMAIL: G �,' ( V' -e n65�,�Lq V VL xi i y u / <br />CONTRACTOR LICENSE #(REQUIRED): �M + L D�i^' <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): UC� ' I ti ' <br />PRIMARY CONTACT: OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />nI 7 ( r1 � f <br />I J C1 J ' I (A 1J V e'L l� <br />CONTACT PHONE: ��( -- .1 Lw <br />f � -. <br />CONTACT EMAIL: �� Gl GI.tC � n- (L h C)o 1 �- i i <br />BUILDING INFORMATION <br />Existing Use of Building: )'�j b VU� 1\ �S � I'/} (-I\N ( �nCe <br />1 <br />Contract Price of Work: $ <br />Proposed Use of Building: 1 l ( I r <br />Heat Source: ❑Gas IfElectric ❑Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑Addition wernodel ❑Regqpair ❑T.I. ❑Sign LISprinkler Demolition ❑Change of Use <br />DESCRIPTION OF WORK: �C'Fit o \N6 `✓ �.> �l1 � V�'�, � �C,E�\✓ Vic\ <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fi <br />Count xture <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump8+Ductless <br />Dishwasher <br />Sink -Residential (kitchen,bath,bar) <br />Duct System (Remodel) <br />Refrigeration <br />lDrinking <br />Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />lWater Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />Roof Drains <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />I <br />jNo. of Heads <br />Chemical Suppression System <br />I <br />INo. 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 I 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 />dna&4AV 0- 6 &11U <br />Owner/Authorized Agent Signature Date (Revised 1011012018) / <br />