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ii • PERMIT APPLICATION <br /> ii al <br /> BUILDING 1 MECHANICAL/ PLUMBING /SIGN / PRINKLER/ 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) PROJECTJTE INFORMATION <br /> PROJECT SITE ADDRESS: .2-'i5i MAITVVY) 27 4'$ ,v-i-td 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): <br /> OWNER MAILING ADDRESS: STREETZ75' 1/IJE('}./I( r✓ F(,(/t.I k.D <br /> CITY FUn -rr STATE WA- ZIP qg?O' <br /> OWNER PHONE: lS•-2' —24 52. OWNER EMAIL: 7mJli t f- o(Ld 1 CON1 <br /> CONTRACTOR NAME: 2E-jam() '1-1/41J 5oi3 <br /> CONTRACTOR ADDRESS: STREET 4161 IV 6LE;J(_(A‘J' &) MI V_ <br /> CITY V f 2 r STATE IA 4- ZIP 477 <br /> CONTRACTOR PHONE: 425 274-3-'1055 CONTRACTOR EMAIL: /aN N) 0- ) CcaG'v i'N -CT- <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: AL 7 .\ILO, // CONTACT PHONE: 3 ) - 74/ -'3.e <br /> T ii ii...b 2 0 s 1 co Ft PC FAC`l4s•-(DO . LLffiet CONTACT EMAIL: <br /> BUILDING INFORMATION <br /> Existing Use of Building: Of/Lf Contract Price of Work:$ <br /> Proposed Use of Building: 01/G f Heat Source: ❑Gas El Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: giCommercial DAccessory Structure <br /> Type of Project: El New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler CI Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: G \ <br /> i nt pvl 710) <br /> l f � J <br /> ktvi3O. 'V' C, ill-Mr ASSOCIATED BUILDING PERMIT#(if applicable): -M q_I nit <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 /> NC—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 Ventilatior 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 i SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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 compl ith the State Contra tors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> • <br /> PER <br /> Owne on ed Agent Signature it/ <br /> o (Revised 4/15/2019) ! <br /> 2- <br />