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� 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 />(Blue or Black Ink Onl Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 7/ Q �� � PROPERTY TAX #: �,� b QO I�O O <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWJVER NAME: `sq ( <br />CONTACT INFORMATION <br />-n�.v��.�— TENANT NAME (!f Commerciall: <br />OWNER MAILING ADDRESS: srRe�l (�j - j� +� (y�,t,{�• <br />�::ITY l �l�.�R <br />OWNER PHONE: '�( �y - a 3 a-535f <br />CONTRACTOR NAME CO�QN�R �S%UNF RG`UF <br />CONTRACTOR ADDRESS: sTFz�.rT /%G.2 y /�S'�� <br />cnY t,�7�',HI�LL <br />T %�vt tJ�'.. <br />STATE �,(,�� <br />owNE� ��nAi�: Nli4. <br />%NG` / NC . <br />R�-�e 6'�,� # / 01 /4 <br />s'rnTe �t%�- <br />'CONTRACTOR PHONE: ,'�S.— �,S _ � CONTRACTOR EMAIL: Cp�QN <br />CONTRACTOR LICENSE #{RE�UIRED}: CQI�/V�j�"f?,.�'„�;,G�IY% CITY OF EVERETT BUSINESS LICENSE #(REC <br />PRIMARY CONTACT: ❑ OWNER C�'G�ONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: 'CONTACT PHONE: ' .y�6—� �18S—D/l/ <br />csARA c,o�2i��6 N, oF��'iC� �%7ANf}(7FiQ CONTACT EMAIL: y��� CpR Lt�F <br />BUILDING PERMtT APPLICATIO <br />�xisting Use of Buildir�c : � Contract Price of or :$ �' • �"O <br />Prr�pnsed Use of Cuildiny; �� " �� Heat Source: ❑G ❑Electric ❑O er <br />E3uilding iype C►3S�FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Fami(y-# of Uni s: ❑Co ercial <br />7ype of Praject: ❑New ❑Addition ❑Remodel �pair ❑T.i. �Si n ❑S�ri kler ❑Demolition �Chant <br />DESCRIPTION OF WORK: <br />� 6U�. �!'1Q.�� � �-7�' fa.� � � � �7R:QiJ �'� S� 7�,� . <br />ASSOCIATED BUILDING PERMIT # (if a <br />71P +��'aO,3 <br />Z�F 9���. <br />CR�iDf�NG. CA�7 <br />uiReo�: 0335G <br />❑fndustrial <br />of Use <br />MECHANICAL PERMIT APPLICATION PLUMBtNG PERMIT APPLICATION <br />Type of ProJect: _New _ Addn _Alteration Repair Type of Project: _New _Addn Alteration Repair <br />tt of List of Fixtures �°f # of # of <br />Fixtures Fixtures Ust of Fixtures Flxtures List of Fixtures Fixfures Lis! of Fixtures <br />A1C — Air Handling Units Heat Pump Toilet Backflow Preventer Inside Bid } <br />Forced Air S si�ms Unit Heater 8athtub 'Urinal <br />Gas Pipin Boiler Lavato Wash Basin Drinking Fountain <br />Water Heater Refri eration 'Shower Floor Drain <br />Gas Fireplace Wood Stove Kitchen Sink & Disposal 'Grease Tra <br />Gas Range Ducting bishwasher 'Roof Drains <br />Clath�s Dr �r H�r�ku�s Other: Clothes Washer Medical Gas <br />Ran�e Hood Water Heater Other: <br />Exhaust Fan Sink (ServicelBarlMopletc.} Other: <br />SPRINKLER I SUPPRESSION SYSTEM <br />Number of Heads <br />ACKNOWLEDGEMENT: ! have reviewed this application and coMirm the information contained he�ein rs true and correct Work done pursuant to thrs permd must comp/y with <br />currenf federal, stale, and local law The granting o/a permi� only authorizes approved woik and no deviafions fhereJiom. Devia[ions must frrsf be authorized in writing /rom the <br />Building O�cial be%re being aufhorized under any circumstance, 1 am the owner, or I am authorized by the owner o/ this property to peAorm the wo�k for which applicafion is made, <br />and l comply with the State CoNractors Law 18 27 RCW and 296.200A WAC. <br />Cify of Everett O/ircia! Use t7rily <br />, �r1.c�Ci �� qZi �O � P T#��� � _�� <br />t7wnerAuthorizvd Agent 5ignature �te jft@v�sod 5/LUl�lif6J <br />