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�� �� <br />I�►'�r,-�- <br />� <br />� <br />PERMIT APPLICATION <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <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 SITE ADDRESS: PROPERTY TAX #: <br />: �s DAKs A�f� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: TENANT NAME (If Commercial):�_1�F..&£ �� fE <br />OWNER MAILING ADDRESS: srReer y,�( I�/�. .� V� <br />CITY STATE � ZIP ���`(� <br />OWNER PHONE: OWNER EMAIL: <br />CONTRACTOR NAME: �. 'j�Q(-,,C � [.Ll.• <br />CONTRACTOR ADDRESS: sTReeT �(,j(j (�../ , T� �-(,. <br />CITY ^ (� � STATE ��L� ZIP �� � .�� �% <br />CONTRACTOR PHONE: �-'�'Z�j �� ]- U�j�� CONTRACTOR EMAIL: DA�I9 C��%'✓�R�'4U�S .��f��'� <br />CONTRACTOR LICENSE #(REQUIRED): y,�2,��(,1_�"�� plv CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): �. <br />PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: Zc� j> ��' _(..�''���! <br />CONTACT EMAIL: � A('`F ` (� �i ^-�✓ � �t'�'/'^� <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: '"�j'-'� F.Fr Contract Price of Work: $ 7�/ <br />Proposed Use of Building: F;(�<F iJF "T Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ommercial ❑Industrial <br />Type of Project: ❑New Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: ��,J ��L�� � �nrJ ��r- 3T��(_ ��N� t-`�JN C-, <br />�n�r� P�-� � �0 4C.1t1 N � <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />�.-'' <br />PLUMBING PERMIT APPLICATION <br />Type of Project: New Addn Alteration Repair <br /># of List of Fixtures # of List of Fixtures <br />Fixtures Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <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/BarlMop/etc.) Other: <br />ACKNOWLEDGEMENT: I have �eviewed this applicafion and confirm the information contained herein is true and correct. Work done pursuant to this permit must comp/y with <br />current federal, state, and local law. The granting o( a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing fiom 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 which application is made, <br />and 1 comply with the State Contractors Law 18.27 R�W and 296.200A WAC. <br />�� <br />City of Everett Official Use Only <br />PERMIT <br />� E�; �i v ( G� � - a� " `� Z <br />Date (Revised 10/12/2015) I <br />