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PERMIT APPLICATIO <br />BUILDING�ECHANICAL / PLUMBING / SIGN / RINKLER / 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.evereriwa.gov/permits <br />PROJECT SITE INFORMATION <br />�-f�'..�� Gl�r'� PROPERTY TAX #:�q..� f�'��-�-� .. �,�5` �"�`.�i --� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER NAME: ��(,)�`��- <br />OWNER MAILING ADDRESS: <br />OWNER PHONE: LI �� ` <br />CONTRACTOR NAAAE: <br />CONTRACTOR ADDRESS <br />CONTRACTOR PHONE: <br />�' <br />CONTACT INFORMATION <br />�?zik' � h.- ; TENANT NAME (i <br />STREET � � t ��- �..Q �c.lai�'t. �.� l�'n'�� <br />CITY C �%iJ-�`�� <br />y-��tiS�U <br />STREET <br />CITY <br />Commercial): <br />STATE LC�T7 ZIP J �-�� � <br />OWNER EMAIL: � C.� 1+�i` � I C°_ � � ✓� `� �� ' �' `''� <br />STATE ZIP <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): �CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTAC7 NAME: �'-� (,7('l�� �;.� G'.,�,r� � y� �;` CONTACT PHONE: �l � � -- �j �j t.j - 5 y � � �ZS -sy W-.,Sy �p <br />CONTACT EMAIL: � �;� ����� <br />BUILDING PERMIT APPLICATION <br />Lvi �s t� i . �-C`%�� <br />Existing Use of Building: ✓�-� c�.c21���1 c�E__ �� Contract Price of Work: $ �% �`�� �� <br />Proposed Use of Building: �"` i 1'Y1 t' �''�t�,--7 i��.+t=.� �� Heat Source: LyJ�as ❑Electric ❑Other <br />Building Type: FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Pro�ect: ❑New ❑Addition ll�Remodel �Repair ❑T.I. ❑Si n ❑5prinkler ❑Demolition �Chan e of Use <br />DESCRIPTION OF WORK: �� J� y�F-C�. 1� YuC-ti�- �.. � d��'�-�i E�c�--C-�-y 1✓��.'!`-�N "�1 - �� �V' •���.�1 Ga� � � - `''�- � ' ' �2..i�-i <br />dtil-�.�i.%" �j-6-� C':�i�'; h..�,'fZ��{y,,,i-, o✓�'t.���--i �)a �'ct�i �', �`��[;y��-'�.z. ,.✓'v-gc�(` -�-1 rr� � 5�, .,�►� �� `�.ta-e:-�i 4 i l��.xa <br />[�� ��-V Ui� l le-�1YT � � l°t,'�..r.fC.t,t�i'-� B-L� ��rM1i�''�E��r-t`? , IS'�' �o.��T' k.?�s�L'Z,t'(��h�� - i WSrF �-r--lr:,��� i���+�'L,ti�'-�'� <br />�ju�d,x--��'vti-uC.�u{- ; �£��'i S''�'1-iL�Z.�v'l-L2�k.��C-�_ i�3`�-li-'��f`S1 4,'�,,r�Scz%1Ga.� `�;r�t�-). V�k'_-�/i:� 'z c�-��C�r i.cr�;� 4��ry�ce.�'� <br />ASSOCIATED BUILDING PERMIT # (if applicable): �y-r�-..� �a.�i2,e.-t-�, !'�-�{�=r-� � «�''«''�=�-c�`, �{�� �r'''7��4�� �`����.i ft��E�k� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: New _ Addn _Alteration Repair <br />Fi tu es List of Fixtures Fixfures List of Fixtures <br />A/C - Air Handling Units Heat Pump <br />Forced Air S stems Unit Heater <br />Gas Pipin Boiler <br />Water Heater Refri eration <br />Gas Fireplace Wood Stove <br />Gas Ran e Ductin <br />Clothes Dryer Hookups Other: <br />Range Hood <br />Exhaust Fan <br />SPRINKLER / SUPPRESSION SYSTEM <br />ACKNOWLEDGEMENT: 1 have reviewed this application and confirm the informati0n contained herein is true and Correct. Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations thereirom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. I am fhe owner, or 1 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 RCW and 296.200A WAC. <br />�� ^ <br />l' �vv � <br />nature <br />City of Everett Offrcial Use Only <br />PERMIT#, � <br />fl �r O�� � � I �V � / �� . <br />Date (Revised 10/12/2015) <br />� / �Z <br />