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MIN PERMIT APPLICATION BUILDING.CHANICAL/ PLUMBING / SIGN / RINKLER/ DEMOLITION 32 EVERETT CITY OF EVERETT PERMIT SERVICE 00 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2 03 7J I JTJ ' PROPERTY TAX#: (90 4(532 d004 OP d LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Jo-Az Vc f"1l 4j TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 7-J ' ✓r CITY fi L/# it STATE (Pi. ZIP Q4 2 d3 OWNER PHONE: Z Jf 2, _ye/qq OWNER EMAIL: CONTRACTOR NAME: ,—(/' •f PlitiA �.1� 11 1 G b y ee..( rik; CONTRACTOR ADDRESS: STREET /( ? 7Y. '41JT zel A CITY f fro,4e, STATE l✓/ ZIP CONTRACTOR PHONE: 'LILT A 99 — .2J d 9' CONTRACTOR EMAIL: 1911ch 4'y / V ) /�d/!. riZt-N, CONTRACTOR LICENSE#(REQUIRED): 1' u P/1 $ 2. L CITY OF EVERETT BUSINESS LICENSE#(REQUIREID): O,S,j Dg 9' ' PRIMARY CONTACT: ❑OWNER tif CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: a/!3 y(c J.? .� Z <j 2 t c CONTACT EMAIL: G" � � h ,%f-/24,0v, ,6/'� z c etc- BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $ v,�'et>• �'2 Proposed Use of Building: .Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: %SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition Remodel ❑Repair ❑T.I. Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: it. frGAYAcc, t/' i2'- 1-6Wk cry,7'z, ('9 ,4m4-1tf 2 a.1 cif Awr J c}.E.-afr ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range / Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher / Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry, mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains 1 Water Heater SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only bhAA PERMIT# y. ?,e5 • nerlAuthoYized A entf gnature Date (Revised 10/10/2018)