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PERMIT APPLICATIOS <br /> BUILDINOVIECHANICAL / PLUMBING /SIGN PRINKLER/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 orBia k Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3lI7 OAKES A✓d PROPERTY TAX#: 0OS2;1700 00 Ot <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> r _. CONTACT INFORMATION, <br /> OWNER NAME: 'roD a0,0 K/t4Ov, Rop( TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 5 '30 &v twee I LA)ve <br /> CITY Llitoge — STATE &VA' ZIP .14.0 3 <br /> OWNER PHONE: S-311')-6556 OWNER EMAIL:TiABEg .oc& pa-.IO .DR6' <br /> CONTRACTOR NAME: KELT* Qzal,LAr/i4(JAM coivAva'b,/ /saaAreS <br /> CONTRACTOR ADDRESS: STREET 31i47 1'1'6,,4rr f}✓L� <br /> CITY ateaer1_ STATE v4. ZIP 10,01 <br /> CONTRACTOR PHONE: S ..1(1j.-(1Lj CONTRACTOR EMAIL:gm f0(,(,t g l Lierlaysliwatok ;;r <br /> CONTRACTOR LICENSE#(REQUIRED):fk (;c tetQOODF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):3763.1- <br /> PRIMARY CONTACT: 0 OWNER L CONTRACTOR ❑OTHER(Please Specify) _*6° <br /> CONTACT NAME: CONTACT PHONE: 1.1)S-1,491-0441 <br /> I4(11 I . U„k CONTACT EMAIL:Olt Sa 0 ALLIELXONm.2vcri .e'er <br /> BUILDING INFORMATION Existing Use of Building:IJ%j)L'M-FAME' Contract Price of Work: $ 5 gt.3-00 <br /> Proposed Use of Building: *Id Heat Source: OGas ❑Electric DOther <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU (Multi-Family-#Units: SO LiCommercial ❑Accessory Structure <br /> Type of Project: ONew DAddition ❑Remodel ❑Repair ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Pa A. 6AMR.00ttit To rite CoMt-tv,✓(rY MOM, caviecr TV ek15rw - /fUTlE5. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count 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 /> r Exhaust Fans(Residential) Commercial Ventilatior 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 Chemical Suppression System No.No.of 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 /> --`� n i �° PER IT On? <br /> Agent <br /> Owner Authorized i n re S g atu ate (Revise 10 0/2018) <br />