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PERMIT I APPLICATIni MECHANICAL/ PLUMBING /SIGN SPRINKLER/ 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) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: -276O5 aewr, „` 4t/Q, GJevr-// Or PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: / i/-/ 4,t„ KJAhV) TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET Z. (-9 5 ( eL.Id(v`e Alig �xy <br /> CITY ,ere 4 STATE 0 C ZIP <br /> % - <br /> OWNER PHONE: Z5)5?2 `?O/U OWNER EMAIL: <br /> CONTRACTOR NAME: 1-'kie ri✓ .4 c�l& �ii1C, /I-o <br /> ` �Y✓�ev Poin4-15 <br /> CONTRACTOR ADDRESS: STREET l s/ 2O4,7c/A �V c <br /> / CITY LJ1C STATE ZIP q7 Sss <br /> CONTRACTOR PHONE: 2 &7 �(�� --7 7 7 CONTRACTOR EMAIL: J J4 i ivt f keg.2 e� GOI/' Ct a'i <br /> CONTRACTOR LICENSE#(REQUIRED): /' u1' L Ei 0 q 9 ae CITY OF EVERETT BUSINESS LICENSE#(REQUI ): — <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Q l'�67 -7Z4a'F <br /> /.c, c Cj(](/l CONTACT EMAIL: (M I / kvt i tee/i.e.- re.) 4 Ul # Lrkvt <br /> BUILDING INFORMATION <br /> Existing Use of Building: 5 +c Contract Price of Work:$ f <"..- U e O <br /> Proposed Use of Building: 9 F-1 Heat Source: .e9Gas ❑Electric ❑Other <br /> BUILDING USE: SFR ❑Townhouse CI Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler CI Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: ,7)00 <br /> rc)e / e'7 PWePi4 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ---- <br /> -- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATIO <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures coupe List of Fixtures C t 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 Pu Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Re A eration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) ommercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Intercept° cease Waste/Water Piping Repair <br /> Exhaust Hood(Reside al) Wood Stove Inter tor-Sand/Oil Water Service(behind meter) <br /> Forced Air Syste Other: dical Gas Water Valves or Fixtures <br /> Gas Fireplac sert/Log Roof Drains Water Heater <br /> SPRI ER/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 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 /> /eL L // 7 / 9 PER #lIr`J /Owner/Authorized Age t Signat Date (Revisyopbnocc_ c>uk <br /> 5/2019) <br />