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® I PERMIT APPLICATIONS <br /> imi <br /> UQLILDNG / MECHANICAL/ PLUMBING /SIGN /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 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2_6,4 /is?/'< Alt:- lwei<--t-2[1 (PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT'INFORMATION <br /> OWNER NAME: Z yl y X 10 rq. L / Ili TENANT BUSINESS NAME(Commercial): <br /> FYYJIIa Le nn -ri ch <br /> OWNER MAILING ADDRESS: STREET ! _L_ <br /> P � .r �%�! ,w'' <br /> CITY STATE ZIP (�q L 6 7 <br /> OWNER PHONE: &j2 5 m t' 5 — 66 6 6 OWNER EMAIL: X d 0 N&- e <br /> G Y`' ( 0 6 I � 00 ^ C6741¢\ \ <br /> CONTRACTOR NAME: \ \rkNi 1_---k e Ci c- 6 C4) <br /> CONTRACTOR ADDRESS: STREET f <br /> _ CITY STATE ZIP <br /> CONTRACTOR PHONE: A i MCRNZB.A2fOR EMAIL: ,- ., �,„ - _ �l / <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQ IRED): 2.O ir <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ATHER(Please Specify) �'is 1 Ai/V�`( DAL_"CONTACT NAME: OQ-CONTACT PHONE: 20V o 332,3 <br /> Nos o s 6 i iLvf r i (a.+& 0205 i p61� 10) CONTACT EMAIL: 1l os t70 CG/,�rr�L,c1�LJ sO. (69,44 9 <br /> o BUILDING INFORMATION <br /> Existing Use of Building: B - iv tAh It'° ,�— Contract Price of Work:$ • + , l• 1�—•o 3 O <br /> Proposed Use of Building: A 2_" t fg��J Heat Source: Gas ❑ lectric, ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse Duplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure <br /> Type of Project: ❑New Addition Remodel ❑Repair XT.I. ❑Sign ❑Sprinkler ❑DemolitiQn.-- lCanae of__Use <br /> DESCRIPTION OF WORK: '1-6 aln,y f 5� a�2S�-f1,4(,�.4 o G14 s 9---. 1oOOQS <br /> roue e Wl�{��i a <br /> 13 ° at, g 1411"g ..___,_„:,) <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 Co t List of Fixtures Count List o Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Pr enter(Inside Bldg) Show b,or Combo <br /> Boiler _ Gas Range Clothes asher 5 Sink-Commercial(,3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless / Dishwasher I" 2,, Sink-Reside ' (kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration ØIa7> <br /> k-Uti ,laundry,mop <br /> entilaon IExhaust Hood(Type II) Water Heater / In deptor if Waste/Water ping Rep ' <br /> Exhaust Hood(Residential) Wood Stove terce r-Sand/Oil Water Se ce(behi meter) <br /> Forced Air Systems Other: M cal Gas Wate /alves or Fixtures <br /> Gas Fireplace/Insert/Log oof Drains -Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM {,'/ Sewage Ejec nor Sump Pump Other: , <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.of Heads <br /> ACKNOWLEDGEMENT.'1 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 1 comply with the State Contractors L 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 3 <br /> Ow r/Autho ' nt Signature Date tij .J/2018) <br />