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47-7" PERMIT APPLICATION <br /> BUILDING IECHANICAL / PLUMBING / SIGN RINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVIGt_5 <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:9 (`6 W Gono± tet- PROPERTY TAX#: 0 c 1s c; 6c1,4Q ,0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No.7 (attach copy of long legal description) <br /> � ��`` CONTACT INFORMATION <br /> OWNER NAME: ►V e.I I -- 5�C�'((("e {qJ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET �16 "JV r�Ar)vd-- St. <br /> j <br /> 'i C CITY -'Yere- �/STATE WA ZIP el I <br /> OWNER PHONE: .40,5 tG -9015 OWNER EMAIL: ‘.5'�}-Z� n rz l c k+nnc i ( .C; r*✓' <br /> CONTRACTOR NAME: 0rvy 1ppr ('S '��fC lam_... p1� \ ,( c> .- <br /> CONTRACTOR ADDRESS: STREET lel 7 fIC(l5-�-- q <br /> CITY IC.Jf✓ <br /> rya SVI STATE V ZIFQ Ja9O <br /> CONTRACTOR PHONE:`-0 •3y1-{-5X53 1(CONTRACTOR EMAIL, c�Ge' <br /> , �, yit c,LlirtscZ. Cc%p`, /N <br /> CONTRACTOR LICENSE#(REQUIRED): ,LOCDINA‘C- I(4:Fie CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 1 CONTRACTOR 0 OTHER(Please Specify) <br /> COMTA(T NAME: CONTACT PHONE: 495 - - -'3 3 <br /> tory \ 13 CONTACT EMAIL: t c 6tY) "C..d t�`1 C o..t\,cc t-v <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:1;2_5kOl-L17 C.-C. ; 5,,h'lc(1ez .,-,.u,_( Contract Price of Work: $ (.D 5, b 00 <br /> Proposed Use of Building: f .c5 IeAe_ric 5-1,a1t(ee,-ary,,t_ ii Heat Source: ❑Gas til Electric ❑Other <br /> Building Type: SFR-Detached ❑SFR-Attached ❑Duplex iMulti-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition 231Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> 'Fir)l' h k9ekse o t.er'vi- Ie wlale. <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 _Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> (4 A/C-Air Handling Units (=- Heat Pump Z, Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems __C.:— Unit Heater i Bathtub C,- Urinal <br /> ec Gas Piping . ----= Boiler Z Lavatory(Wash Basin) (_- Drinking Fountain <br /> Water Heater I Refrigeration J _Shower ,2___ Floor Drain <br /> Gas Fireplace Wood Stove .Q'' Kitchen Sink&Disposal l Grease Trap <br /> . Gas Range Ducting 1 Dishwasher ,r --- Roof Drains <br /> -e- Clothes Dryer Hookups Other: Clothes Washer f;, Medical Gas <br /> _e- Range Hood t Water Heater Other: <br /> 6-..-, Exhaust Fan \ Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I 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 granting 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 under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> -4, <br /> 1 " . C\� PERMIT#n ���D1 h 1 <br /> k&A,A.CiC) ft.,OwnerlAut orized Agent Signatur= ` Date (Revised 10/12/2015) 1z <br />