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i <br /> 4ETTPERMIT APPLICATIO <br /> BUILDINIECHANICAL / PLUMBING / SIG RINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVIC S �N1 ) `--0 \' <br /> 3200 CEDAR STREET, EVERETT,WA 98201 L.( b <br /> (P)425-257-8810 1 FAX 425-257-8857 I(E)everetteps@everettwa.gov 1 www.everettwa gov petm ts' <br /> 0,5 PROJECT SITE INFORMATION <br /> PROD CTS E,�RRD�D--��ESS�;_{ ^ (�`{� /j „ PROPERTY TAX#: <br /> f;tIL FAL LX U61 a / 1-Yi iU� _ <br /> LEGAL for new construction:ttQShort Plat/subdivision Lot No. (attach copy of long legal description) <br /> / CONTACT INFORMATION <br /> OWNER NAME: y/' , /, •�C.CG OD JS i t TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET _aaaa'/►£I Vie- <br /> CITYkijel �t J STATE LOA ZIP (7euO J <br /> OWNER PHONE: ip5-3i,5- '1'/go f:'UI- " P OWNER EMAIL: <br /> CONTRACTOR NAME: 3OLU2. I t Kchal'(l) <br /> CONTRACTOR ADDRESS: STREET G OD5 EZa cro.nd Qu-< <br /> CITY ]i-.. .p.flett7 STATE LA)IA ZIP 8:2O/ <br /> CONTRACTOR PHONE: -O a13 CONTRACTOR EMAIL: j L SOU-k_ a e CQ •Ax <br /> CONTRACTOR LICENSE#(REQUIRED): 500.-Lein - q l 6C •1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 05.330; <br /> PRIMARY CONTACT: ❑ OWNER OONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT N ME• 6,j_t_- CONTACT PHONE: &Q(P _'7/9-O ',3 <br /> 'N I CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ � • — <br /> Proposed Use of Building: Heat Source: ❑Gas $Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: / ❑Commercial ❑Industrial <br /> Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.l. OSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> 'RL-Q - i&- AP. , iaU-1/e4uie 41-5-6\ -- <br /> ASSOCIATED <br /> 1-5-6` — <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn /Alteration _Repair Type of Project: _New _Adds _Alteration _Repair <br /> #of #°f <br /> List of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units f Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air 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 Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> 'Number of Heads <br /> 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 <br /> current federal,state,and local law. The c =nting 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 der any circumstance.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and I comply wi,�the : to Contractors =w 18.2 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> , / �i/� PERMIT. . ( (002...... D i I <br /> 0•T*' er/Aut'• iz•d Agent re D to (Revised 10/12/2015) ,iiivt...,Ti, <br />