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PERMIT APPLICATION <br /> BUILDING /MECHANICAL/PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> "''''� CITY OF EVERETT PERMIT SERVICES <br /> ___ _. 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ( tr o lat-I- ' +Dl iii I I6Fitkitd 'tit tikittiiiiit QI+t.. <br /> PROJECT SITE ADDRESS: (03(k 3(ont P 6 , V\I 51 , Sv(•C 12.5 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> t N` ACT INIORMO:ltilwt' <br /> OWNER NAME: Zek PQpDucT MANAGE MEKT TENANT NAME(If Commercial): 3-pg, PRODUCT MC-IT• <br /> OWNER MAILING ADDRESS: STREET (p311 bTM AVE. W 1 SV CT 125 <br /> CITY ,1JER.Et"r STATE \AJA ZIP CV2n6 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: DAC() Coop- ZILE W EST CA <br /> CONTRACTOR ADDRESS: STREET ?)(625 s. (4.)1 Th ST <br /> CITY KENT STATE VNA ZIP a1lnJ <br /> CONTRACTOR PHONE: 3top.' -S433 CONTRACTOR EMAIL: KMl EW Q t COCOQP• Com <br /> CONTRACTOR LICENSE#(REQUIRED): DPCOC '` O(ZNC CITY OF EVERETT BUSINESS LICENSE#(REQUI ED): S aro <br /> PRIMARY CONTACT: 0 OWNER l .CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> BUX #„ING PEs `I'APP IC 1i`f'IQN <br /> r 1 <br /> Existing Use of Building: Contract Price of W k:$ 2- <br /> Proposed Use of Building: Heat Source: CI Gas Electric CI Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: CI New ❑Addition ❑Remodel CI Repair E T'.I. CI Sign Cl Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: to gms OF PANT RACK INC--• <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> k I ECHANIC 4,1.PER o A'PLICATION v P14#00iNG:PE MIT AP***lt ON,: <br /> Type of Project: _New _ Addn _Alteration Repair Type of Project: _New _Addn _Alteration pair <br /> #of List of Fixtures #of Lis : ixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixture <br /> NC-Air Handling Units eat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash in) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplac Wood Stove Kitche nk&Disposal Grease Trap <br /> Gas Ra Ducting Dis asher Roof Drains <br /> Cl. --s Dryer Hookups Other: othes Washer Medical Gas <br /> -ange Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUP.PRESSIOI SYSTEM ` ,`r <br /> Chemical or Water ' No.of Heads <br /> ACKNOWLEDGEMENT:I 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.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!comply with the State Contractors Law 18.27 - Wand 296.200A WAC. <br /> City of Everett Official Use Only <br /> PER I # <br /> //-ham 2f32 ` q " <br /> Ow /Authorize. �gna 1 re Data (Revised 9/23/2016) <br /> I <br />