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021'021'2017 02: 58AP9 4259496 AP•1ERICANSTARPOEING PAGE 01/01 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN I SPRINKLER/DEMOLITION <br /> CIN OF EVERE17 PERMIT SERVICES <br /> OOL 3200 CEDAR STREET,EVERET!",WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8867 1(6)everettepa@averettwagov j www.everetty a,govlpermR& <br /> Blue.er Black Ink Only Plestse PROJECT SITIE INFORMATION <br /> PROJECT SITE ADDRESS:7/V 33'- ST E\/CRETT t DA ?aa. o/ PROPERTY TAX#- 0405(o /9s0 Co 00 5D / <br /> LEGAL for now eonstNc tion: Short Plat/subdMsion..._ __ - -- Lot NO. (attach copy of 1-9€opal description) <br /> CONTACT INFORMA'T'ION <br /> OWNER NAME: TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS: sTRwkf ET7/`� 33~ ST. /TO <br /> crry -jea-ETA STATE Lx)A ZIP 7 C�2- <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 4M6,0 fe-,4.•) 57-AQ E,aTE 15ES . 17iOG- <br /> CONTRACTOR ADDRESS! s i r a'vc '3)( ➢L. (,J <br /> crry xf,Q STATE A zip9 80 Vo <br /> CONTRACTOR PHONE- YA57 410S.- /O(Oj 1CONTRACTOR EMAJL:R�►ti1D`J <br /> CONTRACTOR LICENSE#(REQUIRED): 6PUSEIR 7/PO, CI'T'Y OF EVERETT BUSINESS LICENM#(REOUIRED): <br /> PRIMARY CONTACT: -K-6W4r--p CONTRAC-fOi ❑OTHER(Pleaae Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> © <br /> ZAAW ZdAPL rj CONTACT EMAIL:5.4 /FS AA0,197 <br /> BUILIMNO PERMIT APPUCATION <br /> 'i=-)dsbng Uses of Building: Contract Price of Work:$ <br /> Proposed Use of Building: Heat Source: OGas 171Heculc ©Other <br /> Buildin T : OSFR-Detached ❑SFR-Atiactzed Qbu ex 0Mu1t1-F8mi -#of Units: 17GOmMercial ©Industrial <br /> T of Pr ect: ONew DAddltion CqRemodel OR air ❑T.I. Elsign ❑S rfnkler QDemolition E3Cbangacfuqa <br /> DESCRIPTION OF W K: <br /> P�}'��cE Sffd�J n V"� C-\IE ` rJE2?E/L <br /> ASSOCIATED BUILDING FERMfC# if applicable): <br /> MECHANICU PERMIT APPL:IUTION PLUMISING PERMITAPPLICATION <br /> Typo of Projevt: _Now_, Adan Alteration —R*mir Typo of Project New _Adan Aftarat3on _R*pslr <br /> FtxklreS L1454 of Fixtur" Liar of rbrwrae F7xturrse Lfat o/rtxturoa Of L/sl of Flxturea <br /> FfmvaB <br /> A/C--Air Hand€i Units Haut Flump Toilet Backflow Preventor Irneide BI <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> t3as n Boiler Lavatory ash Basin i?rintdn duntain <br /> Water Heater Ret0enation Shower Ploor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&01s 1 Grease <br /> Gas Range Ductinq Dishwasher Roof Drains <br /> Clothes D er Haoku Other: 06thas Washer Medical Gat <br /> Range Hoa! Water Heater Other: <br /> usuat Fein $Ini. 3ervicclBar/rAo fctc. Otl�ar, <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water INO,of Heads <br /> ACKNOWLEDGEMENT:I haves reviewed this epplicatlon and eon"the Infomwuon contained herein is Yue and conacL Work done pursuam ro Zhi$pAmvt mustcwriPrY w1m <br /> mnunf fadwW,slate,and local law. Tho Drarmg or a parmlI onll`®uthorfzlls appYDverJ Wbrk eAtl rt0 rLevl9Uarl.S rRonSham.DoviaHona butt!Asst 6e authonaeU fn wrtbrxJ him fha <br /> Building Off 0l bWm Aeing authorized under any Grcumaunce.I am UV owner,or I em outhonzad by tree owner of mis pmper8.to perform the work for which aWficabbn Is made, <br /> and!Can•Ipty with the Stefe Corltn Cm UW 18.27 RCW and 296,MA WAC_ <br /> City of inveigh Omclal use Orly <br /> PER I •#-� <br /> -De. <br /> owrrr Q Ag* Signator* Date (Revised 9/23!2018) <br />