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PERMIT APPLICATION <br /> BUILDIN MECHANICAL / PLUMBING / SIGh - - DRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVILL, <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: L-�-� j ��-�� L L% PROPERTY TAX#: �C'CS/CA�'.7,� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> r CONTACT INFORMATION <br /> OWNER NAME: &��� tnn."i N TENANT NAME (If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY 1 STATE toV 71P <br /> OWNER PHONE: V i) —J-2 1 J 9 7I ,t OWNER EMAIL: <br /> CONTRACTOR NAME. _�Vf AIZAA&Cf�,166-S <br /> CONTRACTOR ADDRESS: STREET 2-2-9 /Y10/Al <br /> CITY ;�644 STATE ZIP qO / <br /> CONTRACTOR PHONE: z/Z-S `fgl—9 r° CONTRACTOR EMAIL: �a'v1NEEyE�✓E/ mew <br /> CONTRACTOR LICENSE#(REQUIRED): J(4 N 61' FS 06 _i✓ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 3 Lf,PRIMARYCONTACT: ❑ OWNER ZCONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> :J CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ y c r_ <br /> Proposed Use of Building: 5 r-- Heat Source: �GaS ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached SFR-Attached El Duplex []Multi-Family-#of Units: ❑Commercial ❑Iindustrial <br /> Type of Project: ❑New ❑Addition Remodel ❑Repair ❑T.I. []Sign ❑Sprinkler ❑Demolition El Change of Use <br /> DESCRIPTION OF WORK: <br /> i�—�l�/-�/^�� c��: /�c�,��trA/� �<1C �/�/�I>✓c:r .n n/��v✓ <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 /> ( A/C-Air Handling Units 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:/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 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the S to Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMv IIT <br /> Owner/Authori tArl <br /> ignature Date (Revised 5/20/2016) <br />