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Jon, 11. 2019 9: 22AM No. 1852 P. 1 <br /> • • <br /> PERMIT APPLICATION <br /> "- BUILDING/M1GI-IANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION • <br /> Girt OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425 257-8810 I FAX 426-267-eBv7 I(E)everetteps@everettwa.gov I Hw,wevereL[wa.gov/permi[s _ <br /> tiiri®-or black Iilrk©nkfr_ptaAse) • ippliNi 6T$ INFOiliVMATI_ON <br /> PROJECT SITE ADDRESS: -34 (o, 4I) ?' D/U ' [PROPERTY TAX#: c`aoY. 3C 37DC) <br /> LEGAL for new construction: Short Platlsubdlvleion -_ot No. (attach copy of long legal description) <br /> Conti t itakiiitviATI©1EQt . . , _ - <br /> OWNER NAME: (�D I Zlld j Y TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3 boJ�W 114o1LL( <br /> (46 Bk j ' - <br /> CRY evon." ' STATE G4A 77p %p O 0193 <br /> OWNER PHONE; OWNER EMAIL: <br /> CONTRACTOR NAME; EUte2G '5`I~!rU' �t`{C�d"N�6't•"A-i. <br /> CONTRACTORADDRESS: smear 2I' - e�rGl c AU Eir . <br /> • <br /> rr 'cv-1 • STATE (, 4- zip 6t Sgo/ <br /> CONTRACTOR PHONE: 4'2'5+'iS 2.3I I t - CONTRACTOR EMAIL: /14/4iG 4 /0-l/1,Cr."- <br /> CONTRACTOR LICENSE#(REQUIRED): E(J�s`}'2f.�js cp2sp�' 1CITY of EVERETT BUSINESS L.fCENSE#(REQUIRED): 49 6 S", 'w <br /> -xv:., -rr�r'- �,Y,-ter, ��,�....,,,x_...,,..� ���h._....� <br /> PRIMARY CONTACT: IA OWNER IacoNTRACTOR LI OTHER(Please Specify) • <br /> y CONTACT NAME; CONTACT PHONE: t4 7 5..2.5-2._'°)//(� <br /> /VL CONTACT EMAIL: 44144 gp 5'A4U14 b' <br /> • - ." Bmi,1i1PTa fibAlittlrAop.IL1dATIOd ' • . •. • • ' - <br /> Existing Use of 8ulldfn': O C) Contract Price of Work:$ t 560 <br /> Proposed Use of Building: MD C,C11V1L-#&% Heat Source: t (Gas CIEfeotrle pother _ _ <br /> Bulldln'T 'e: IASFRDetached OSFRAttached CIDu►fax I:Multl-Family of Units: OCornmerclal ❑industrial v <br /> Type of Project: ❑Nevi OAddltlon LIRemodet feRepalr MT.!. EISlgn OSprinkler ODemolltlon ClChange of Use <br /> DESCRIPTION OF WORK: - <br /> u D@ 1-0( 6; 6 op( I)6 U,` z mtirl . <br /> ASSOCIATED BUILDING PERMIT Cif applicable: _ <br /> ,11/ll-CI4(t1UICAL ptkIfillf/0121L[CATI011! . ' . PLUMBING PVIllitlJT APPLICATION <br /> Type of Project: _New_ Addn _Alteration,^Repair TypeotProject; _view Addn Alteration Repair <br /> F/xturas List of Fixtures Fixtures List of Fixtures Fixtff ures fst of Fixtures Fixtures List of Fixtures . <br /> NC—Ala'Handling Units Heat Pump Toilet — Saclttlow Preventer(inside Bldg} <br /> Forced Air Systems Unit Heater Bathtub Urinal • <br /> Gas Pjafn t Boller 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 MedIcat Gas •' <br /> Range Hood _ Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/eto.) Other: <br /> I-. : :.�Pt [ > (,Elk]d,uPPI i$sto sysTEM <br /> 1 !Number of Heads <br /> ACKNOWLEDGEMENT:Mays ve reviewed this application and confirm the In!'ormaflon contained herein is free end carted Work done pursuantto JAI permit must comply with <br /> currenf federal,state,and local law.The granting of a permit onlysufhortzes approved work and no daviations therefrom.Deviations must first be authorireerin writing from the <br /> Building official before being authorized under any clroumsiance.1 am the What:orlam aulivorized by the owner of this properly to perform the work for which application is made, <br /> :rndI comply with the State Contractors Law 1B,27RCW end 298•200AWAG. _ <br /> CifyofEvereftOfficial Use Only <br /> LPERMIT# <br /> ,7- 03c-.)- .________ (LI( /I V <br /> OwnerdAuthorlxe 4 ntSlEinature Date (Revised 5/20/201) • <br />