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PERMIT APPLICATIO <br /> 1111.11 BUILDIN ECHANICAL I PLUMBING/SIGN*RINKLER/ DEMOLITION <br /> EVERETT 32 CITY OF EVERETT PERMIT SERVICES <br /> 00 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: 551�j 3eJev-\\( IN PROPERTY TAX#:CiGq 1 17Qoc,c7 4$0.5 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT-+ INFORMATION <br /> OWNER NAME: % \ —b��k nos (yt.(JJf57", TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE LA. ZIP <br /> --tt <br /> OWNER PHONE: L 125 60 I 2S 2S OWNER EMAIL: �c ck e ho ( l 9 e-,,,,,,, I / Cafv► <br /> CONTRACTOR NAME: '-\oM,e_. CJW(Ver.. <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: )G�AA,l t� � -,� CONTACT PHONE: �6s 32_Co.44 <br /> CONTACT EMAIL: 2 C.„A.` (res,-0,-'d.est9r-ts,cam <br /> BUILDING INFORMATION o ,� <br /> Existing Use of Building: 'F'(� Contract Price of Work:$ Z J C t.av'0 <br /> Proposed Use of Building: P. Heat Source: DGas arElectric DOther <br /> BUILDING USE: 'iSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units:, ❑Commercial ❑Accessory Structure <br /> Type of Project: :New DAddition VtRemodel ❑Repair ❑T.l. ElSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: A «5 6.e i rie,..„3 Ciw Q► Gr, e(Neat--c),C- v,,-,S / (It )L.Jtvlo <br /> W . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATIO PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures baur Li Fixtures Count List of Fixtures Count ' of Fixtures <br /> counNC—Al andling Units s Piping :;ckflow Preventer(Inside Bldg) 3 Sho r,Tub,or Combo <br /> Boiler Gas Range I, CI. es Washer ink-Commercial(3-comp,prep,floor) <br /> I Clothes Dryer //. Heat Pump&Ductless I Dishw.•her Sink-Residential(kitchen,bath,bar) <br /> _ Duct System(Remodel Refrigeration Drinking tarn Sink-Utility,laundry,mop <br /> 1_Exhaust Fans(Residenti Commercial Ventilation Floor Drain 3 Toilet <br /> — <br /> Exhaust Hood(Type (Not Heat/AC system) Hose Bibb Urinal <br /> _Exhaust Hood(Ty. II) r- .ter Heater Interceptor-Grease Waste/Water Piping Repair <br /> —, Exhaust Hood esidential) Woo. ove Interceptor-San. • Water Service(behind meter) <br /> Forced Air -stems Other: Medical Ga , - -r Valves or Fixtures <br /> Gas Fir• ace/Insert/Log Roof Dr.' s I Water •. r <br /> SPRI, LER I SUPPRESSION SYSTEM ' S- , =ge Ejector or Sump Pump Other: <br /> Water Supp sion System No.of Heads <br /> Chemical Suppression System 1 f 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.lam the owner,or lam 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 /> (lizo <br /> PERMIT <br /> c.\ .k,,�,c + '1rZ:-(P�Lr Co 2 Oa9 <br /> Owner/Authorized Agent Signature Da (Revised 10/10/2018) ,j <br />