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013/20/2017 07 : 40 #2308 P. 001/002 <br /> 0 • <br /> PERMIT APPLICATION <br /> BUILDING I MECHANICAL I PLUMBING/SIGN /SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-2578810 1 FAX 425-257-8a57 I(F)everatteps@everettwa.gov I www,everettwa.gov/perrnits <br /> "7�0 <br /> kMA7T 6' <br /> PROJECT SI E DRESS;OA0973 f7—_f PROPERTY TAX <br /> 4-Y W I - <br /> LEGAL for newconstructlon, Short Plat/subdivialo Lot No, (attach copy of long legal description) <br /> ,,T 777 1,77 7,777, <br /> ,, T, 77777,7,7, '127' toud'i RFoW 75fF, <br /> OWNER NAME: 1C &tj C&N TENANT NAME(if Commercial), <br /> OWNER MAILING ADDRESS: <br /> My STATE ZIP <br /> OWNER PHONE, 71 1OWNER EMAIL: <br /> CONTRACTOR NAME: X Al <br /> CONTRACTOR ADDRESS: sTRearA�gel <br /> CITY APIAlf--M27- STATE ZIP 20t-Q-/Tlz <br /> CONTRACTOR PHONE: Y.)-r &2� ICIONTRACTOREMA$L: <br /> CONTRACTOR LICENSE#(REQUIR5D):& <br /> �A AlXf 0 Yle CITY OF EVERETT EUSINESS LICENSE#(REQUIRF-0):0//.343 <br /> PRIMARY CONTACT, 0 OWNER L)CONTRACTOR M OTHER(Plasso SpOCIfy) <br /> CONTACT NAME, CONTACT PHONE: Yr 2,71 .7 2 <br /> CONTACT EMAIL; <br /> �N <br /> Existing Use of Building: lContract Price of Work:$-2b/go <br /> Proposed Use of Building:SPA- Heat Source: OGas 2tfectrlo MOthar <br /> BuildinqType: LIVR-Detached CSFR-Attached 00uplex MMulti-Family4of Units: 00ommercial 01ndustrial <br /> Typeol'Project: MNew CAdditlon MRemodal MRapair OT.I. OSIgn ElSprinkler MDemo[jtion LIChangeofUse <br /> DESCRIPTION OF WORK: <br /> [Z r P (ACE EuV7kic FUR-�4'CI6 <br /> .ASSOCIATED BUILDING PERMIT (if applicabla):_ <br /> �"777'7 moo,15WEAZ rlgokpFp �y <br /> Type of Project: _New— Addn __,Repalr Type ofProject: _Naw __Addn ­Alteration ---Repair <br /> #of LIST of Fixtures # I Is r of Fixtures #of List of Fixtures #of List of Fixtures <br /> F)xturos FI)etaras Fixtures Fixtures <br /> AIC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside BICdIg <br /> Forced Air Systems Unit Heater Bathtub urinal <br /> Gas Pi [n Boiler �avato <br /> H_Cyyash Basin!) Drinkinp Fountain <br /> Water Hater Refrigeration Shower 1 Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trae <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryar Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other, <br /> Exhaust Fan Sink(ServiceJBarJMop/atc,) Other; <br /> [Number of Head6 <br /> ACKNOWLEDGEMENT.I have reviewed this application and Confirm the InIbrmallon contained herein Is true and correct Work done pursuant to this permit must comply with <br /> current federal,state,W/opal law,The granting of a permit only authorizes approved work and no rieviallons therefrom.Davi3tlons must first be authorized in wiling trom 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 w he State Contractors Law 1827 RCWand 296,200A AAC, <br /> City Of EVeratt Offlaal Use Only <br /> PERMIT <br /> /7&Aofthorlzed Agent Signature Aata (Revised 1a�12/2015) <br />