2201 100TH ST SW ALLEGION 2023-01-03

F • PERMIT APPLICATI011p BUILDING I MECHANICAL I PLUMBING I SIGN PRINKLER/ !EMOU ION E A f= CITY OF EVERETT PERMIT SERVICES 4� 3200 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_2,-0 ( / 0�� 1 i ✓ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Gise.. Go r J/,'D LLC TENANT BUSINESS NAME(Commercial): R-/ � /&A/ OWNER MAILING ADDRESS: STREET �Q/! � I3 J . -)2 141A /� CITY -v� l J /�`,STATE Vv1' ZIP ,8 Zd 3 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: /��C f fly c GIG' \/ Niel CONTRACTOR ADDRESS: STREET /erg 30 & gbh /A-ve S/,�Nit / 7 CITY � e " /-- STATE t J 1 / ZIP ( 3(___)� CONTRACTOR PHONE: jO6, 6 28:J V X2 CONTRACTOR EMAIL: (nJ �/ZA) / /n ,Q,24fl, 1 CONTRACTOR LICENSE#(REQUIRED): i(e..7/yte w 4 2.yD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1.2- t'?211 PRIMARY CONTACT: 0 OWNER ILI ONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: ,, 6v V 1 i to f� , CONTACT PHONE: 2 Z 6 -4 7 6 976, , ' v/ ,05 CONTACT EMAIL: 4J �02/veli e1/yleCI� J/C4) ,CiW BUILDING INFORMATION L� Existing Use of Building: 5 11/� Contract Price of Work:$ / .5/ r9 - / a� Proposed Use of Building: C 7/LJ AC 2G 1141 Ma/0W Heat Source: ®Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: E}Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel EiRepair ❑T.I. ❑Sign ❑Sprinkler El Demolition ❑lChange of Used/ I' E, DESCRIPTION OF WORK:, C 1 Airq e \ u * ; r ; S,43...v ' ifOo/ V o f /`/ v ( UP t 415 W ) 1- -- L. ► k.e Foe l l c e_ /--t!7`6 ()iv r 5 . 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 Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 1 iNo.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 I1 , C/�r / ' �._ (� PERMIT OO I — 6�al�,/ Owner/AutIp ized Agent Signature Date (Revised 4/15/2019)