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PERMIT APPLICATIO <br /> MI <br /> BUILDINIPMECHANICAL/ PLUMBING/SIGNIMPRINKLER/ 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 I www.everettwa.gov/permits <br /> (Blue or Black Ink Only)Please) ;{ ROJECT SITE INFORMATION, <br /> PROJECT SITE ADDRESS: 6 ear-de r /< PROPERTY TAX#:ogo qO 2-Ck:40 ',00 <br /> LEGAL for new construction: Short Plat/subdivision //7tPWC0eP sc Ai a r'Lot No.2 4 (attach copy of long legal description) <br /> ,_ -... ,_, :: CONTACTINFORMATION,.,. <br /> OWNER NAME:Pi, #Q7land GL C (Commercial): f f /arid 7m,5`y <br /> fTENANT BUSINESS NAME Commercial QC <br /> OWNER MAILING ADDRESS: STREET t 5/fl 64r.eaG�eV'a / 2 V fcoae !CITY n franc/$G Q STATE f j74/.. ZIP (I /fi// <br /> OWNER PHONE: q15 28& , 5�j4.8 OWNER EMAIL: k#15.,bc j4ch prvert ies.conl <br /> CONTRACTOR NAME: �! <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR OTHER(Please Specify) Arco/feG7` -€4 ehf . /. ownev <br /> CONTACT NAME: CONTACT PHONE: &(.—ev5 5 _ j SOO ,,t <br /> /OrJsrvi /GO4h d vde CONTACT EMAIL: ivr an CD ronit dl dearchc?'& S,G010j <br /> - BUILDING INFORMATION -' <br /> Existing Use of Building: Cuctvekeese/Distr;44h Url Contract Price of Work:$�000 <br /> Proposed Use of Building: GoarehoVse`aSYP/ all75O.7 Heat Source: IZGas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: iglcommercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel DRepair , I.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: UPt °774C Q/fir plan f (2 ) <br /> S <br /> rn 5 r /167er (r.2ae7 ex/s7'/7 a ,,SW1 �,va// //4sf4// a) h/i sf, <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> IV/A MECHANICAL PERMIT APPLICATION R/jf4- PLUMBING PERMIT APPLICATION <br /> Fixture FixtureFixture <br /> List of Fixtures List of Fixtures Fixture List of Fixtures List of Fixtures <br /> Count Count Count Count <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 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 /> 1/(�SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Wa er 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 Of ' fore being.uth.' -. ,nder 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 mply wit he State I. aw 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> �./ 7. PEW V� o Ca, -02 <br /> 20751 1 4 <br /> Owne uthorized Agent Signatur Date (Revised 10/10/2018) , <br />