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imil PERMT L PPLBCATBOi MI BIM iIBNCWECHANBCAL I PLUMBING I S)GNWPf 1NKLE(• / ©EBBIBOLBTBON EVERETT CITY OF EVERETT PERMIT SERVICES 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: 2-46 Qc i C,\-k k SA" G'(/et/t l `&- PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 0 k r i.S{- tcv C yr c-, c:c-+ TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET i 1 3L \ t✓ L_o,ti-t5 le-\v,-C. r)t>_1J(- cm, L.t\1e.-{ S -)Lv("i S STATE W)/a, ZIP 1 S L , OWNER PHONE: Z__C -Sv Cc.i 7S OWNER EMAIL: L'- r r clf.JTt-rc`cA Cr. e fr-o T r"tct, L Cca:\ CONTRACTOR NAME: (_;L_;AJ L v- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: DOWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: La 7 SZ C ,__` _) t`-_ t _? CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: ) Y2 Contract Price of Work: $ > ,- 0 Proposed Use of Building: ' ' Heat Source: ❑Gas OElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: fie- (-/),,c- ,,,v ,•,/ ct 0rv-j r Dr]y}Wcw,- ,,,i •Crr_• 4J•'S aP-t'fC-t / Ili Jl/41`�"/ qd(-VA +A)/r L 14-Fr i(A) a r ea` / ` Ie 1 c Ci'Yt Cam -- -(, / ? '' 'I" 5 F i 7U res ; Cj v-et c,cU c,s fi ,re !Jl-Ace. - ASSOCIATED BUILDING PERMIT#(if applicable): r 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 i Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer I Heat Pump&Ductless i Dishwasher 1 Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain _J- Sink-Utility,laundry,mop - Exhaust Fans(Residential) Commercial Ventilation ) Floor Drain ;,_ Toilet • Exhaust Hood(Type I) (Not Heat/AC system) Z- Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair t Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures i 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 -No.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 PERMIT# Owner/Authatized agent Signature Date (Revised 4/15/2019) ) fZ