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PERMIT APPLICATION <br /> BUILDIN&ECHANICAL/ PLUMBING /SIGN / ADINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1311 O -IiwiA (�— . PROPERTY TAX#: 1$D53000 L/D6 800 <br /> LEGAL for new construction: Short Plat/subdivision Lot No (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ��/ef-C-ti 'U LL.0 TENANT NAME(If Commercial): �{ 1 <br /> OWNER MAILING ADDRESS: STREET 2862 � njQ pRE's hfs Orf of // A (j //� <br /> CITY SC1irt� Ane- STATE C A ZIP `1 L�O <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 11"Acvcr c i n Q,na mue(4 iSl VI <br /> CONTRACTOR ADDRESS: STREETI 2(00y , C 0t S . {A{ Q 2 <br /> CITY Ali, \Jlf'r Q✓� ISTA(T�E WA` ZIP <br /> CONTRACTOR PHONE: 3(00>� Zt4 - I-6Z5 CONTRACTOR EMAIL: STct0VI;c@ M�Y�rs� v�.cowl <br /> CONTRACTOR LICENSE#(REQUIRED): MEYC D3SQ ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 2A,L, L' <br /> PRIMARY CONTACT: ❑ OWNER .CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: QQ C CONTACT PHONE: �3(00� �ZN GZS <br /> She nye Lnc�uib'+ �UGiICY JeCVOSS CONTACT EMAIL: S�C1�ntC � �Y12 �5i .CDv� <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ 6,500 <br /> Proposed Use of Building: I Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Fa ily-#of Units: %Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. Sign ❑Sprinkler ❑Demolition []Change of Use <br /> DESCRIPTION OF WORK: 2 Alum irt(Aea woM :sign-s, Z ivi' -erlor may,eewl5 i I luw,i n c'fcd <br /> Signs, l ,,,wcdgc siov) <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.1 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 /> Ll <br /> PERMIT# — <br /> I <br /> Owner/Authorized Agent Signature Date (Revised 5/20/20 6) <br /> \{ 2— <br />