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<br /> �P)-1�5-''•r-F�ti ��\-S�� ^ '_gg5� �jc1?\'8f2�fB�5�AV?f2;I\Y8.901'� w.�veretnva.gov/permits
<br /> (Blue or Black Ink Only Please) PRDJEGT SI"fE INFORMATION
<br /> ' PROJECT SITE ADDRESS: �.0�I L � PROPERTY TAX#:
<br /> LEG�1L i�or n��v c-onsiructlnn� Shor;Pial'su�.iicis�vn Lo��1'a {aita�`a cooy of I�na legal descrio±ion)
<br /> CONTACT INFORMATION
<br /> p��t'NER NAM[: �r�� � � (,��'"1Q� (�,�j TENANT�JAh1E (If Commercial):
<br /> OWNER MaILING ADDRESS: sr�:�e- ('� � �'
<br /> � �,n� ,(J�' '�, -a-� � =jP �� �
<br /> '; OWNEF PNONE: � � 2Cv 'r'J� 04VNER EhtAIL:
<br /> CqNTR�\CTOR NAME: �,��� �-��,G-���'��-5-
<br /> CONTRACTOR ADDRESS: s�,se- �-}�5 � � Q l�.
<br /> e.-`� �--�-- vU� _,= �-1'�Zo!
<br /> CONTRACTOR PHONE: � (,1�� CONTRACTOR Eh1AIL: �Cir.G�11 e. � �rn��a.�-►►�G • �1'n
<br /> CONTRACTOR LICENSE#iRE(;UIR�n�; C(Yl��-�Cl ('1-L�'l�"�"Zd�'� ICITI'OF EVERETT EUSINESS LICENSE r(REQUIRED): !t�P��
<br /> I:
<br /> � PRIMARY C�NTAGT: ❑ (�4�,���� �CON i�AC,TQR ❑ �;THE��Piease Sp2ci`�-t �
<br /> k CONTACT NAME: • CONTACT PHONE: � a�4 �
<br /> �L1�1��� CONTACT EMAIL• ���b�� �'���,-�-jr1 . � ry�
<br /> � BUILDING PLRMIT APi'LICATIDN
<br /> ��� �xistin Uae of E�auildiiiq: Contract Price of VYork: g_ ��J�C� '—
<br /> �
<br /> �� Proo�se�f Use ol Bu�l:iinn �ea`5�wc=: ^as ❑�le;,tri� ❑p,ner
<br /> Building T����e: SFR-Detached �SFR-,a,tache:i ❑Du�'ax ❑4iulii-ramily»o�Uni,s: ❑Commercial ❑Industrial
<br /> � ry���+ol Froie�;;I' ❑��1etc ❑�ldditic�n ❑r�e^��iel ❑Re�air ❑T.l. ❑�ion ❑Sorinkl2r ❑Dsmolition ❑Change of Use
<br /> � DESCRIPTION OF WORK: � 10.C� as r
<br /> � � � � ��
<br /> � ASSOCIATED 6UILDING P[RMIT# ��f n;•i�ii�;;-le�; �
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<br /> MECHANICAL PERMIT APPLICATIOIV PLUMBING PERMIT APPLICATION
<br /> , Typo of Project: __�Ne�� _ Addn _Alteration _Repair Type oi Pro'ect: Neiv
<br /> J _ Addn Alteratlon Repair
<br /> ��'f #eF #of #of —
<br /> n Flxturr.s List of Fizhues List of Fiztures
<br /> Fistures List otFixfures
<br /> � Fizuves Lisf of Fixtures
<br /> •4'G-Air H;�nd;in Urnts u Fixtures
<br /> q eit Fur�,� Tci e; 8ackflow Preventer(Inside Bld
<br /> �, r�rre�i�\ir:vstems Uni?Neater �,
<br /> ' �3`h`�r Urinal �)
<br /> �: Ges FiF�inq E:ile; �
<br /> {i -ava:cn��l^,'ash casin) Drinhing Fountain
<br /> \Vater f;eater ne.'ricera,;en c,
<br /> 1Cl\'@�
<br /> Gas Fireplace ����» ���`..,, Fleor Drain
<br /> G�s Ran e .� Kitcnen Sin^g p;c���a� Grease Trao
<br /> �uctirq �s n��sher
<br /> �Jelhc=s Dr�er Hockt�p5 :;i-,er: Roofi Drains
<br /> _f;anr,e Hocd C':cthes�1'asner Medical Gas
<br /> E:xhra��s:r=�z� --.. t�ta±er Heater Other:
<br /> ��ri:(�en�ice�Ear.;�lcw'etc.) Oi,.er.
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<br /> SPRINKLER 1 SUPPFtESS10N SY57EM
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