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MN PERMIT APPLICAT <br /> M BUILD ING/MECHANICAL/PLUMBING /SIG /SPRINKLER/DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES °L coax' <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 /> 2 <br /> PROJECT SITE ADDRESS: 5 25 R.u.etc er• ire. c t ,2c'\ PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Sava ice TENANT BUSINESS NAME(Commercial): ici.4-jdY� <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE - ZIP <br /> OWNER PHONE:„ OWNER EMAIL: <br /> CONTRACTOR NAME: So.t d 4.4"Senn ifi ce, 4Prb{ec ,ttw. <br /> CONTRACTOR ADDRESS:-4-f STREET ,j,yka_vcy�.n ��. , Ca p� t,i t 'lb `*?y aba fe55•) <br /> CITYTvitw`(a, 1 STATE IAA ZIP el b 1 845 <br /> CONTRACTOR PHONE: SO 3 8sSs1 3 n D CONTRACTOR EMAIL: ziepc e• Sa 3erk re ,Cd6.41 <br /> CONTRACTOR LICENSE#(REQUIRED):S ATJ n F pais Mr CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER >ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Sd"3 gfyq 3‘.0 <br /> Gee'C'C' Se o CONTACT EMAIL: 4Q Sa,nda Csik,a.c. �- csvt <br /> Y BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$ l Doe. • 6.0 <br /> Proposed Use of Building: Heat Source: OGas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ; Commercial DAccessory Structure <br /> Type of Project:,.ew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition DChange of Use <br /> DESCRIPTION OF WORK:=h4 1.1 -K4t)Z U4,3oo r:')hclni.� CM_ S.w <br /> A-rsv�.. crts'5;ay. =./S ie Mk) <br /> ASSOCIATED BUILDING PERMIT#(if applicable): W\Q.bO ot.0 <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 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/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System is. 1 S nbrt,(ylo.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 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ( I=2'i 2 ��O L 2d?.D PER �D/ 90 <br /> Owner/Authorized Agent Sign ate (Revised 10/10/2018) `� (� <br /> 1 <br />