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PERMIT APPLICATIOII <br /> BUILDING t MECHANICAL / PLUMBING / SIGN WPRINKLER / DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3o5 SE EvE/ZE-rr "ALA— wAY 4i 8 9$208 PROPERTY TAX#: 2$0$/8 0030y 300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: G J7LE AXN7A L TENANT BUSINESS NAME(Commercial): Ges•N7GE NA/774 L <br /> OWNER MAILING ADDRESS: STREET 9900 S. LA CIFnJ G.P QL.VO 57E $oo <br /> CITY /hi OA W 000 STATE GA ZIP 9030/ <br /> OWNER PHONE: 360 41'i9 S6o 3 OWNER EMAIL: <br /> CONTRACTOR NAME: fl6A7/-1 A/O127,14WJES <br /> CONTRACTOR ADDRESS: STREET 27/0 /O4174 S7- C.- S• -, QC <br /> CITY /./4KFwt0p h i 1 STATE WA' ZIP 9�v <br /> CONTRACTOR PHONE: 253 4'95 7o9r CONTRACTOR EMAIL: q b,os n an new rh fl dr7"1 WeS4-- 6()AI <br /> CONTRACTOR LICENSE#(REQUIRED): MEA7r1A/r9t/7Z CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: D OWNER 'CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253 y 95 70 9 f <br /> QQi Ilk ask/An/ CONTACT EMAIL: bbr0snanehea-/IOr Wes} • Cos+, <br /> BUILDING INFORMATION <br /> Existing Use of Building: MEOKAL. : 1-EAI-7/4 5EL,viGFS Contract Price of Work: $ 5610C)• o0 <br /> Proposed Use of Building: As60'4..4r. ! /1h(,7/./ SE,evsCES Heat Source: OGas ❑Electric DOther <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: XCommercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: INS>Ac•L- (I) S/ F SE of /1_L..uMINA-76o CHANNEL' (.E77C/2-S Gti /L}GFw.4y <br /> REA01N(, " GENTLE DEN7AL <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count <br /> List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—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 Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb 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 Fireplace/Insert/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 No.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 1 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 co\ <br /> 9 <br /> s tho'.•. .41%% rii ature Date (Revised 10/10/2018) 1 f <br />