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BUILDING�ECHANICAL / PLUMBING / SIGN �RINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVIC <br />� 3200 CEDAR STREET, EVERETT, WA 98201 <br />,'P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATiON <br />PROJECT �l � E ADDRESS:� �� � w� ���,��� �� ��� � PROPERTY TAX #: � C� �� �, � � �i �; y �,� ,� � � L � � <br />t" <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legaf description) <br />CONTACT INFORMATION <br />OWNER NAME: j}�G{LI�Yi � �Ci��C t{�'�'1�/L� ���� S TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: srReEr Gi ��� i���' ��Y`Q (�, <br />CITY � STATE VU� <br />OWNER PHONE: y L� � Z�"T U� S� 1C '1 � OWNER EMAIL• 1� �� S G�� V�(� C( C� I,� <br />CONTRACTOR NAME: `1 i� �ICI E� �-�' � <br />CONTRACTOR ADDRESS: sTReer I �7 �C� <br />CITY <br />� S 1Zi I( C.�-� 1 C.� 7 � �l? C-- <br />H' �1�% X �(�l � � �� <br />STATE <br />ZIP �� � <br />ziP �f �i L% �j l <br />CONTRACTOR PHONE: �-�� S- � �� CONTRACTOR EMAIL <br />CONTRACTOR LICENSE #(REQUIRED): (�{(�V i� f� 1 I�'; %' <.� � CITY OF EVERETT BUSINESS LICENSE #(REQUI <br />PRIMARY CONTACT: OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: � L�,��jL)— S?� IG � <br />� I� ��"'" —�' CONTACT EMAIL: �� � S Ci G4 1r� ��, (j �,( U�✓' <br />BUILDING PERMIT APPLICATION <br />Existing Use of Buildin : �V1(' � VVI � � �'I L�.�-- Contract Price of Work: $}�(,� � �� <br />Proposed Use of Building: '1/t; ;ii�l�4 �� Heat Source: as ❑Electric ❑Other <br />Building Type: SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family�# of Units: ❑Commercial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chang <br />DESCRIPTION OF WORK: �� nlu� �X IS11��'lf� C�,CiS `� iY �iI (�(�, �,�1 ��'L1 ✓) t'vil C%� %i S�' n �.%'��( � <br />S 1� V� w �-�i� hv X G� v� c� 1; u v✓��'' � � 1 e c h� � � i� �� ne r��r�' �'i-I-e ai �-c�c� <br />ASSOCIATED BUILDING PERMIT # (if applicable <br />MECHANICAL PERMIT APPLICATION <br />Type of Project _ New __ Addn _Alteration _Repair <br />Fixtures List ot Fixtures Fixtures List of Fixtures <br />A/C — Air Handling Units <br />Forced Air Svstems <br />Water Heater <br />Gas Fireplace <br />Gas Range <br />Clothes Dryer <br />Range Hood <br />Exhaust Fan <br />Heat Pump <br />Unit Heater <br />Boiler <br />Ductin <br />Other: <br />SPRINKLER / SUPPRESSION SYSTEM <br />❑Industrial <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br /># ot List of Fixtures #�f List of Fixtures <br />Fixtures Fixtures <br />Toilet Backflow Preventer (Inside Bld ) <br />Bathtub Urinal <br />Lavatory (Wash Basin) Drinking Fountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roof Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/etc. Other: <br />ACKNOWLEDGEMENT: 1 irave reviewed this applicafion and confirm the information contained herein is true and correct. Work done pursuant to this permd must comply w�th <br />current federal, state. and local law. The grantiny of a permit oniy 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. 1 am the owner. or I am authorized by the owner of this property to perform the work for whrch application is made. <br />and 1 comply wrth the State Contractors Law 7827 RCW and 296.200A WAC. <br />��/�� /��_ <br />� <br />Ciry of Everett Oflicial Use On/y <br />PERMIT # � � � , ,�` �� D� � <br />►/1/111�� <br />1-�--ij'- <br />