Laserfiche WebLink
11/28/2016 10: 20A1v1 42594978876 Ah1ERICANSTARPLI!ht1FTNG PAGE 02/'02 <br /> PERMIT APPLICATION <br /> BUILDING f MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 i FAX 425-257-8867 t(E)everetteps0everettwa.Gov I unuw.everettwa.gov/permit& <br /> Blue or Black Ink Only Pleas* PROJECT SIT IE ikFOAMI4TIOM <br /> PROJECT SITE ADDRESS: MAIL bP-' e-VC,0rS 7, Q$azo S PROPERTY TAX 40; 00 8y3[oot�oo 33 0 0 <br /> LEGAL for new conbtructlon: Shat Natisubdiv%lcm Lot No- (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(ff Commercial): <br /> OWNER MAIUNt3 ADDRESS. sTPZU 91 o(o u). M191--L- t�P-I JE <br /> crrY E J CJi-e T i STATE t Jit ZSP 9'a 108 <br /> OWNER PHONE: ya S 7�O - 13.7 ! CG OWNER ENIAIL: <br /> CONTRACTOR NAM Ay1&fg,Q,.1 Slit �tEr1.g .J <br /> CONTRACTOR ADRRI:SS: sTr ,Z .3�f AL GJ <br /> Ctly t STATE W A ZSP $O <br /> CONTRACTOR PHONE: YZES 4/09 /O Q CONTRACTOR EMAIL:94a 4s <br /> CONTRACTOR LICENSE Cmr OF EVERETT BtJSINS-SS LICENSE*(REQUIRED). <br /> PRIMARY CONTACT: © OWNER 0 CONTRACTOR OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> QAaJ�Y QAOn] CONTACT EMAIL: <br /> BUILDiNii,ipaRMff APPLICATION <br /> E)OsUN Use of Bulidi Contract Price o�frWork- <br /> Pr sed Use of Building: Beat Source: 1*as OF-saculc C10"r <br /> Buiidln T 0SFF2-Detached ❑SFR-Attached 13Du cx ❑Mulct-Famil -#of Units: 0Commer6al 12lndu5trial <br /> 7ypeofPrujtact: 13Npw ❑Add}lion ❑Remodel ftepair OTJ. 0sign ISS rinkfer 1]Dgmolition QChan a of Uea <br /> DESCRIPTION OF WORK: <br /> ASSOCIATED BUILDING PERMIT# l icahle <br /> MECHANICAL PERMIT APPLICATIOAN PLU1 13010'PERwr APPLICATION <br /> Type of Pro}pct _Now Addn _Alteration ,_Rapelr Type of Project: _New —Adan _Alteration _Rspalr <br /> FJxtures Llet of Flxtwes Flkrurss LJst of FJxiutw Flxtunas 0 Of List of Fbrtures of Us of Fixtures <br /> Rxtutoa <br /> A/C--Air Handling Units Heat Pump Toilet Backnow Preventer Inside Sidg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory ash Basin Drinlung Fountain <br /> / Water Hester RefrE eration Shower f=loor braln <br /> Gas'Fireplace Wood Stove Kitchen Sink&DIsposal Grease Trap <br /> Gas Range Ductin Dishweaher Roof Drains <br /> Clothes b er E-iooicups Other: Clothes Washer Medical Gas <br /> Ran a Hood Water Hester Other. <br /> Maust Fen Sink Other. <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> umber of Pa s <br /> ACFGIOWLfOei<M�NT f have,revlawed rhls appllcatlon and confrrm}rya inr«1nwt11n eonte/ned herein is true and comsat.Work done pursuanr to this pamvt hWdt co rPty with <br /> current tedarel,state,and iota!few.The gtantlbg of a permit Only crulhor&uu approved worn end no devla6ons 8tereftw.Deviazlons must Brat be authorized in writing tram H,a <br /> Bulld/ng OfWal before being eumoroed under any urcumstancae.i am me owner,or i am auuwtzad by the ownar of this property to perform the work for whkh Wlicamn is made, <br /> and f Mmply With the State Contractors Lew 78.27 RCW and M.200A WAC. <br /> City agvamft Dl ore/Usv Only <br /> PER T I1 ,,C _ r <br /> Owner/Authorized Agent Signature Date (Revised a/2a16) <br />