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= • PERMIT APPLICATIOS <br /> BUILDING / MECHANICAL I PLUMBING I SIGN I 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: 27-7 3 L (A.Lr,T(.f10(LE. — "1 - -c DM( PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT BUSINESS NAME(Commercial): :LLO k..Q <br /> OWNER MAILING ADDRESS: STREET 2,12jt 1i4 b 9 <br /> J CA2.f CITY VAPN, STATE ZIP It)Zoti I <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Re..t&C) 1 1 r <br /> CONTRACTOR ADDRESS: STREET 410 1 E L_E/Tt't A\tfA.S OVA VL <br /> CITY £‘J E,r(c — STATE J 3,Pc— ZIP 98'2,6 <br /> CONTRACTOR PHONE: 41-S-- 43 - gOSS CONTRACTOR EMAIL: 1?...1.. .1 pti,)•St A,S (4_ 1 C Lo u.p • OW- <br /> CONTRACTOR LICENSE#(REQUIRED): Of) s Cl ¶ ^0 i►4 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) 5 4 - <br /> PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR POTHER(Please Specify) <br /> CONTACT NAME: Ott_ T1941.0((, CONTACT PHONE: 3600-54u -322.3 <br /> T1t 4u it, asiG7J p2CitriE i$ CONTACT EMAIL: -^qy wiz pes reins Al2cµ q -tco .cOM <br /> BUILDING INFORMATION <br /> Existing Use of Building: p l(.,e. Contract Price of Work:$ TA EPiD <br /> Proposed Use of Building: ( -f-((,F' Heat Source: ❑Gas 0 Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ODuplex DADU El Multi-Family-#Units: raCommercial ❑Accessory Structure <br /> Type of Project: ONew ❑Addition ticiRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler Demolition OChange of Use <br /> DESCRIPTION OF WORK: 0V„- SWOT__ tA ftLLS '--- NDp r)LlT 'POOR elk 1AKLt-5 • <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count 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 Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain _Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System I lNo.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 ply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official <br /> UseO m y <br /> i l �� PERMIT <br /> ID.3/Q <br /> 0 I thorized Agent Sign Date (Revised 4/15/2019) (/Z <br />