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NMI PERMIT APPLICATIC) <br /> In <br /> BUILDING ECHANICAL E PLUMBING L SIGN RINKLER 1 DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-M10 I FAX 42—2574857 i(E) e'= w.sgov 7 weity.everettwa.govipennits <br /> (Blue or Block ink Only Plebe)` PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: (p 2© 5�. \Jere*F YY10 II UJo j t S-i-c2dPROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT BUSINESS NAME(Commercial): Fre SGi j "(I(a 1 <br /> OWNER MAIUNG ADDRESS: STREET t j)2.0 e. ; ,\1 e;,(,e k}- mad l l,1/4)Al 5Aei 'L(J O <br /> CITY (�ite e, - STATE f'A ZIP 9 8 C 1 a <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: p,p,£ 31 s ri 9,ervice.s <br /> CONTRACTOR ADDRESS: STREET I(OJ.I 2.- BO*et I -E VQ.Y_-1- 44.4y p-02 31 /� <br /> cm alit 1 CrcaK STATE �A ZIP 980/2 <br /> CONTRACTOR PHONE: )-{ZS• 330.SKoO CONTRACTOR EMAIL: 6 b t-Sig hS e t'Y1S h•COIN <br /> CONTRACTOR LICENSE#(REQUIRED): p)e7S I C( Ctr) CITY OF EVERETT BUSINESS UCENSE#(REQUIRED): Q 55 I O4 <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Fran)K C7df1Za l.e,S CONTACT PHONE: 1.1. . 330, DA b O <br /> CONTACT EMAIL: -Signsp msn-Corr) <br /> BUILDING INFORMATION <br /> Existing Use of Building: (Coin rY e,r C14,1 Contract Price of Work:$ 3-/ 9 5• Ct) <br /> Proposed Use of Building: Heat Source: DGas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ElDuplex ❑ADU ❑Multi-Family-#Units: VrCommercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair DTI_ ,Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> in S=ral1 C1 ) L0J 5 tr C\\SPIal <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> tree ture Fixture <br /> List of Fixtures Count List of Fixtures Count List of Fixtures CF List of Fixtures <br /> NC-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bubb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fueptaceilnsert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System I No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and cones 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 ham the <br /> Building Offer before being authorized under any circumstance.lam the owgrer,or am authorized by the owner this property to perform the work forwhielr applicabrAn is made, <br /> and l comp*with the Side Ccobw...lar Law 18.27 RCW and 296.2O 4 WAC. <br /> City of Everett Official Use Only <br /> A 10. a Z0 PEA#2 .� �oo ? <br /> OwnedI> S re Date (Revised ff3/2of8j <br />