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4k77- • PERMIT APPLICATION• <br /> BUILDING I MECHANICAL I PLUMBING /SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (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:2300 ki"- I u"et`TFk-• EL) Y PROPERTY TAX#: 2 4--0.0 %?Cx�, ' <br /> €N..,i-i ' lcry,r(JEapiT,Ir`;A iE"e 3 <br /> LEGAL for new construction: Short Plat/subdivision _ Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: RAIN ER, Pia Pa(Ql � .k-(,,,> TENANT NAME(If Commercial): 5 4, b �� illiCA <br /> OWNER MAILING ADDRESS: STREET 9 �(, <br /> 3 2E .c...AU _ SC,.J �lei e- "f���" <br /> ,. p \ <br /> CITY Q_(v gyicy\J STATE ZIP 4k30J' './ <br /> OWNER PHONE: OWNER EMAIL: /� <br /> CONTRACTOR NAME: 1-8Al l vL(� CM U h Y i <br /> CONTRACTOR ADDRESS: STREET j U3,6 Cl/i -h U <br /> CITY €4 e `-'t STATE vN7t ZIP l vz I <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): fl tvv Ly}e/4 3 13 1,6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): I `j 05( <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR L`T OTHER(Please Specify) A O A(i�I C-A f"J r <br /> CONTACT NAME:{ CONTACT PHONE: J2 5) S -)./ '3 <br /> PM)L CONTACT EMAIL: t.,-QC-P 961 Z, C�t' C,Lt 1c. et ,, ' Ce_71".1. <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: F. -I Contract Price of Work: $ I g- 14._ <br /> Proposed Use of Building: 'i Heat Source: ❑Gas DElectric��❑Other - <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: LiCommercial 0 Industrial <br /> Type of Project: ❑New ❑Addition DRemodel ❑Repair DTI. ❑Sign ❑Sprinkler ❑De olition ORqfle of Use <br /> DESCRIPTION OF WORK: „a g-pp t-xv�atA" 6:, v of-Q.../e .. 4,f ` <br /> tlJ S/� �i�nG��Jc4� 6Lir, eF are_e--i WCX L c� 'PS^ <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 13-t I <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration _Repair Type of Project: New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures _ Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler _Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration _Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> _Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Chemical or Water I 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 /> `f� / City of Everett Official <br /> l Use Only <br /> % 7/V ( � PE #'1 I2-'6 V5 <br /> Owner/Authori4, <br /> Agent Signature Iff to (Revised 9/23/2016) <br /> k <br />