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PERMIT APPLICATIO <br /> no <br /> BUILDING I MECHANICAL I PLUMBING /SIGNIPRINKLER/ 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: 214 Sell :51-ilit?er PROPERTY TAX#: OOS7&©0002i <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> �,4 CONTACT INFORMATION <br /> OWNER NAME: 141it St O 1 I mUrf5 1 t LLL. TENANT BUSINESS NAME(Commercial): pool, kwtaluCz1t4( <br /> OWNER MAILING ADDRESS: STREET p 0,Gt$ 4S9 <br /> CITY EVE/t IT STATE INK" 1 ZIP gE2,p� <br /> OWNER PHONE: 42. 7 01 <br /> - .07o0 OWNER EMAIL: phei, ,ifId Q U.o fail (2K <br /> �CONTRACTOR NAME: ii A q 0t <br /> CONTRACTOR ADDRESS: STREET A,�j2 f' erc 7r{j OWQ P LL -JE <br /> CITY E-/ gML. <br /> �� 2 <br /> STATE (Ai Pr ZIP <br /> CONTRACTOR PHONE: 42.c 2.,j9 e[ 2.2 CONTRACTOR EMAIL: agayte & 80 creaky rt1 t CCM,/ <br /> CONTRACTOR LICENSE#(REQUIRED): ,J Vi,1st L S cc_ i Ol 4(& CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ,,OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONT NAME: A ` CONTACT PHONE: 4Z5 7 G4— 0 700 <br /> Ve. I�I,C-w(,.A*N-26 CONTACT EMAIL: p AeLtAU,144 `'�+n ‘-jetf<ekVa rY`Q..1 <br /> BUILDING INFORMATION Cli.—, <br /> r <br /> Existing Use of Building: ST-IN-IZ{;� I.AMI A l'IV-itL'(�t2_0kg, Contract Price of Work:$ 7 <br /> Proposed Use of Building: 1+,4,4 Heat Source: ,Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU OMulti-Family-#Units: Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition , f emodel ❑Repair ❑T.I. ❑Sign DSprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Re-MOO et, eV-t5riti/c, TO L<Li I2,o01,5r-- <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 Fi - Count List of Fixtures Count ist of Fixtures <br /> A/C—Air Handling Units Gas ''.Ing Backflow Preventer(Inside Bldg) ower,Tub,or Combo <br /> Boiler :.s 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(Reside ) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Ty.- ) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hoo ,Type II) Water Heater Inter or-Grease Waste/Water Piping Repair <br /> Exhaust,rrH.i d(Residential) Wood Stove erceptor-Sand/Oil Water Service(behind meter) <br /> Forceyri 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.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and I com I with the State Contractors w 18.27 RCW and 296.200A WAC. <br /> City of Everett Official'Use Only <br /> 1 1/ / l� PER # C.�� l <br /> 8 <br /> Owner/Authorized Agent Signature Date (Revised' 1/2_____ <br />