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PERMIT APPLICATIO, <br /> BUILDINOPMECHANICAL I PLUMBING /SIGNORINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-2p7-881 0 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ..... PROJECT <br /> PR(? ECT SITE ADDRESS:_,_, <br /> ;2 Z4 <br /> LEGAL for new construction: Short Plattsubdivislon Lot No. (attach copy of long legal description) <br /> 7:: <br /> OWNER NAME: F­,J TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS: sTRE 7—Cp2cJ -. J�OJ Nf--- <br /> F�0;2-7zz::� CITY IF STATE WA ZIP <br /> OWNER PHONE., OWNER EMAIL: <br /> CONTRACTOR NAME: L"­J N F=" <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: OWNER 0 ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ,,, <br /> CONTACT EMAIL: 6V-a­,e- eo(pe rv,.5-t,-) <br /> CONTACT: 0 ONTI <br /> M <br /> FNE <br /> DIP\ <br /> EPERMIT APPLICATION <br /> Existing Use of Building: )Z o,-" 0 lContract Price of Work- <br /> Proposed Use of Building: JHeat Source: as ElElectric F-10the <br /> NSFR El Aulti-Farnily-#of Units:,,. ElCornmercial [Industrial <br /> Building Type: J -Detached EISFR-Attached -ODuplex ❑I <br /> Type of Project: El New MAddition ❑ []Sign OSprinkler OlDemolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> Pi~PL-t'��— Vii' (��}s �v�i cam'/"TL".��5 i <br /> ,ASSOCIATED BUILDING PERMIT#(if applicable): <br /> �ItAMIT�A.PPLIIOXTJION <br /> ... ....:.-J: <br /> M.ECH "PAVPERMIT... PL <br /> ICATION.: PLUMBING Type o:f I Project: New_ Addn Alteration Repair Type of Project: New ___Addn __Alteration ___Repair <br /> of #Of <br /> #of List of Fixtures #of List of Fixtures List of Fixtures List of Fixtures <br /> -Fixtures Fixtures Fixtures Toilet Fixtures Backflow Preventer(inside Bldg) <br /> ,FJC——Hand Heat Pump—Air <br /> ForceddKir Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain. <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting —.Dishwasher Roof Drains <br /> Clothes Washer Medical Gas <br /> Clothes Dryer Hookups Other. <br /> Range Hood Water Heater Other: <br /> [Exhaust Fan Sink(Service/Bar/Mop/etc;.) Other: <br /> .............. <br /> " <br /> SP;RINK <br /> QE TRX�SSI­ON,:A-YAT-9 <br /> INumber of Heads <br /> ACKNOWLEDGEMEN I P 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./am the owner,or/am authorized by the owner of this property to perform the work for which application is made, <br /> and lc y with he State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett official Use Only <br /> PERMI]MkI,or <br /> OWnerlA orized Agent Signature Date (Revised 1011212015) <br />