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(P)425-257-8890 FAX 425-25/-Stab/ I (t)evereuepsl_eveleuwa.yev I Wvvw.GVVcuvva.yvvrN „ ,. <br /> ;laid a �1��1 lluak® iiy ply ��) Alk 0.40ikOT S9TE WOftMA`HTId <br /> OJECT SITE ADDRESS: L f A A L: PRO RT TAX#: <br /> GAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> INNER NAME: '� rZA,-ST t 'Jt �IIG�6 TENANT NAME (If Commercial): <br /> VNER MAILING ADDRESS: STREET <br /> clTv E <br /> `% J STATZIP L <br /> JJ�CC <br /> JNER PHONE: �/��� �y7� ''L�'J� < OWNER EMAIL: <br /> ,NTRACTOR NAME LIJC,k'- �� � 1 Mher � A <br /> ,NTRACTOR ADDRESS STREET 7-b �4 G-fi't t� <br /> I STATE ZIP <br /> CITY r � <br /> NTRACTOR PHONE: CONTRACTOR EMAiL: -&5A-+-wee. eo <br /> SS�-�2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): � <br /> NTRACTOR LICENSE#{REQUIRED)' L f/' <br /> IMARY CONTACT: ❑ OWNER NTRACTOR ❑ OTHER(Please Specify) <br /> NTACT NAME: CONTACT PHONE: d-7 Z 2- <br /> CONTACT EMAIL: <br /> :..BUILDING. PE RMIT:APPLICATION <br /> Contract Price of Work: <br /> sting Use of Building: $ <br /> posed Use of Building: Heat Source: VGas ❑Electric ❑Other <br /> [ding Type: FR-Detached ❑SFR Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> ,e of Project: ❑New ❑Addition El Remodel ❑Repair i. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> SCRiPTI/JIO�N�OF WORK: �^ <br /> A Coe <br /> 30GIATED BUILDING PERMIT#(if applicable):.­_ <br /> MECHANICAL PERMIT R :A <br /> APPLICATION PLUMBING PEMITPPLICATION <br /> e of Project: _,New _ Addn Alteration _Repair Type of Project: _New Addn —Alteration ,_,Repair <br /> t of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> tures Fixtures Fixtures Fixtures <br /> C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldt <br /> A/ <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 /> SP>FtpNKLOZR J S_19pp.gESSION'.SYSTEM <br /> Number of Heads <br /> NOWLEDGEMENT:1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> of 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 /> ing 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 ma, <br /> comply with the State Contactors Law 98.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> � ,+1,,A- 1 Ant Ginnafiira Date (Revised 512012016) <br />