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� <br />Apr 13 16 02:56p <br />� <br />� <br />Air Ductors Cor� <br />BUILDtNG / ME <br />(P) 425-257-88�0 f FAX <br />rrtVJ CL 1 Ji 1 C HUUKGJJ: �� �^ S� „y� � t � <br />d` 1/1 <br />LEGAL for new constructian: Short Platlsuhdivislon <br />owN�R r�amE: C�i.IYGI� OF �i V�YIe M�bti- E <br />OWNER MA]LING ADDRESS: srr�eEr !�}"�{ D� S1 <br />arr �1�1��(-�- <br />OWNER PHONE: fVl�r�- 1-�a j�j�jp 3sQ3 <br />CONTRACTOR NAME: �'( I� �y C`�DYS� 1 VZ G, <br />�0-659-9624 p.1 <br />PERMIT APPLICATION 7�,��vPCt� ��� �� ��S ��r <br />NICAL / PLUMBING / SIGN ! SPRINKLER <br />� � a <br />, C. C�,►� <br />CITY OF EVERET'1" PERMIT SERUICES �`�J�/�/�-� ' <br />200 CEDAR STREET, EVERETT', WA 9820� �{E �ti �" °' �'� i �� � <br />5-257-8857 �(E) everetteps@everetlwa_gov � www.everettv�_ f�}�i <br />JEGT SITE INFORMATION <br />�, PROPERTY TAX #: mY�� � OOS I(� QjS3 �Q f% O O <br />r�� <br />Lot No. (attach copy o! long legal description) <br />>NTAGT INFORMATlON <br />'�'i �'(- TENANT NAME (ff Commercial): <br />)?Y�t �- �1�t/i', <br />OWNER EMAIL: �-- <br />STATE VVH ZIP <br />CONTRACTOR ADDRESS: sTaE� a- �' N� n� <br />��TM MQ 5� i� sraTE � za ��7G�D <br />CONTRAGTOR PHONE: �� OZi— q� b� � CONTRACTOR EMaL: O�1 L� @ R��dUG�I'S, h��I-- <br />CONTRACTOR LICENSE #(REQUfRED): A-I EL�I{ f� I Gi 3 fv � CITY OF EVERETf BtfSWESS LICENSE #(REQUIRED): O�7 ���� <br />PRIMARY CONTACT: ❑ OVJNER � CoNTRACTOR ❑ OTHER (Please Specify) <br />CON�iACTT1AME: CON7ACTPHONE: ��.. Ci�J,� 3 r�g <br />(�}'Q✓1d� �II.GC�lnhi 5 CONTACTEMAIL: OtTIGe �Q(!"��-fL{�Q} 5', },�}- <br />BUIL ING PERMIT APP�IGATiON <br />E�asting Use of Building: �D� ����11 TO Cns' QC'f i Contract Price of Work: $ �d -(� <br />Proposed Use of Building: Heat Source- �Gas Electric ❑Other <br />Buildin T pe: ❑SFR-Detached ❑SFR-Attached ❑ uplex ❑Multi-Famil -#of Units: �ommercial ❑Industrial <br />Type of Project: ❑New ❑Addition �Remodei �Re air ❑T.I. ❑Sign ❑Sprinkler DOemolition ❑Change of Use <br />DESERIPTION OF WORK: �e�,�� ,�JUS�I�JYI�{ �i G �ii'1GtC2.. CY�Si7i3%1 � %�L`' �YYICIL�S �� °1S� <br />� �'I ��t�'',� CWi tm1 f�n' St{sl-�m ZOYI � G� h�,w -�ied'rnos-���- <br />A550CIA7ED BUIL�ING PERMIT # (if applicable): �C u-� �n/bY{L 'j� �2 d(JY�� � �:f (jFd �j 8� .0 <br />MECHANICAL P�RMIT APPLECATION PLUMBING PERMIT AFPLICATION <br />7ype of Project: _New _ A�dn �Alteratian _Repair Type of Project: New Addn Alteration Repair <br /># of # of ^ # of — <br />Fixtuias List ofFi�rtures F���S List of Fiutu #�f List ofFixlures List of Fixtures <br />Firlures Fi�ciures <br />A!C-Air Handlin Units Heat Pump Toilet Backflow Preventer (Inside BI <br />Forced Air Systems Unit Heater Bathtub Urinal <br />Gas Piping Boiler Lavatory (Wash Basin) Drinking Fountain <br />WaterHeater Ref� eration Shower FaoorDrain <br />Gas Fireplace V'Jood 5tvve Kitchen 5ink 8 Disposal Grease Trap <br />Gas Range �ucting D�shwasher Roof Drains <br />Clothes Dryer Hook�ps Other. Cloihes Washer Medicai Gas <br />Rarge Hood Water Heater Other: <br />Exhaust Fan Sink (5ervice/Bar/Mopfetc_) Other: <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />ACKNOWLEI?GEMENT.• I have revrewed lhis applica�ion and conhrm th informairon contained he�r� is true and conect. Wak done pursuant to this pem�it rr�ust canpJy wilh <br />curran. federal, sta(e, and locel /aw. Tire granting of a permit onfy authoii es approved work and no deviah'ons Sherefrom. Deviations �nust first be authonzeJ in writing from the <br />BL'l,ding OfHcia! betore be�ng authorized under any c/rcumstance. / am [h owner, or! am aufhorized 6y lhe owner oi ihis properly to perform the work for whlch application is made, <br />orrd l comp/y with the Sfoto Conhacfars Law 18.27 RCW and 296.200A AC. <br />�C�Ty ol Everett D�ciel Use Only <br />� PERMIT � <br />�'���.�-�� � �� j 20 � (� , � � � a � " d �J � <br />OvmerlAuthorized Agent Segnature Date (Rev/sed 70/12/2015) <br />