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Nov 24 15 02:50p Air Ductors Corp 360-659-9624 p.2 <br /> • <br /> PERMIT APPLICATION <br /> BUILDING/ MECHANICAL I PLUMBING 1 SIGN 1 SPRINKLER 1 DEMOLITION <br /> OOL CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 w w,r_everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: a �. PROPERTY TAX#: ar if 00tZ 1.3 300005500 <br /> t`ti'1ds Lot No-Ps- ,attach copy of long legal description) <br /> LEGAL for new construction: Short Rlat/subdivision PO >? �— <br /> .! I CONTACT INFORMATION <br /> rOWINERME: Lf ndA i QGK. l TENANT NAME(If Commerciaq:ILING ADDRESS: srRe rSr QS�Upa{��Sfi- k)' <br /> CITY `-"• 1 S ATC W r"Y ZIP I Q <br /> OWNER PHONE: LI2s 349 Za Oq OWNER EMAIL: <br /> CONTRACTOR NAME: Ali- DQ I nc <br /> CONTRACTOR ADDRESS: sTRE=r q 4Z$ IS(St P1 N� <br /> N►A svt t S-ATE WA ZAP 2x10 <br /> clrr n� <br /> CONTRACTOR PHONE:3(po VD-1 q&11-1 CONTRACTOR EMAIL: OFFt C.G glydu�`br'S t <br /> CONTRACTOR LICENSE#(REQUIRED): AT.R DU D1932-N 3 <br /> CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): !ISO <br /> PRIMARY CONTACT: ❑OWNER N CONTRACTOR ❑OTHER(Please Specify) /�"" <br /> CONTACT NAME: Brav)dee MGGI nn IS CONTACT PHONE: 3(0 O b5 (a9 L{ <br /> CONTACT EMAIL: ()PP7 G�C� Qtl'f4Ll c�t'S.M+ <br /> 7�d <br /> i BUILDING PERMIT APPLICATION g <br /> ExistingUse of Building Ivl SIN Ie-'�limI I �S_IILt Yl C� Contract Price of Work:$ U <br /> Proposed Use of Building: (M�'S1I7 rQS1 U_ Heat Source: ®Gas ❑Electric ❑Other <br /> Building Type: ;KSFR-Detached ❑SFR'Attached []Duplex ❑Multi-Family-#of Units'. <br /> ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑i2emodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> - M4 tt, rglkeM(!-1 and gddLN Air Wdttl alnev <br /> ((Z1ftrA--h1N,) . CneY►)) <br /> ASSOCIATED BUILDING PERMIT#(if applicable)! <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: g_New Addn 25Alteration Repair Type of Project: --New Addn Alteration `Repair <br /> #Of, ___Repair <br /> #of #°f List of Fixtures <br /> #of List of Fixtures List of Fixtures List of Fixtures Fixtures <br /> Fixtures Fixtures Fixtures <br /> !L'C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Unit Heater Bathtub Urinal <br /> Forced Air Systems Drifting Fountain <br /> Gas Piping Boiler Lavator (Wash Basin) 9 <br /> Refri eration Shower Floor Drain <br /> Water Heater g <br /> Gas Fireplace Wood Stove Kitchen Sink S Disposal Grease Trap <br /> DuctingDishwasher Roof Drains <br /> Gas Range Medical Gas <br /> Clothes Dryer Hookups Other: Clothes Washer <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/Mopletc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Number of Heads . <br /> ACKNOWLEDGEMENT:I have reviewed this aopucation and confirm the information contained herein is true and correct Work done pursuant to this permit must comply with <br /> current federat,state,and local law.The granting ora permit only authorizes approved work and no deviations therefrom.Deviations must first he authorized in writing from the <br /> Budding Official before being authorized under any circumstance.1 am the owner,or i am authorized by the owner of this property to perform the work for which application is made. <br /> ano I corirpiy wan t!c S(atc ContraaforS Lair in?7 RCW and 296.200A WAC, City of'Everet#Oficial Use Only <br /> PERMIT# s <br /> OwnerlAuthhoorize Agent Signature Date (Revised JO/17l'015) <br />