2916 STATE ST GRX2 LLC 2018-02-09

Oierr— • PERMIT APPLICATIOP BUILDING / MECHANICAL / PLUMBING I SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 i FAX 425-257-8857 i(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 'PROPERTY TAX#: k5fib 3 lv`lnj(�2_1( f`lito Sst-4e *. It.lv3 ; iwiie'vx✓e, wi!`tB2Li LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: htVC•Y Adk:1_ - t- ,1-1....A., TENANT NAME(If Commercial): el}max d 1 t_L.L.- OWNER MAILING ADDRESS: STREET (9O( ) (fart k►:&. 12 tic CITY t� t.�,l ' STATE W[4 ZIP 1si 2 -/ 1 OWNER PHONE: 3 to -- (Q< ' - ayes{ ( OWNER EMAIL: MD-nrk r Owes-Wn.SiYUL -`t c;(') v..-:,Prx CONTRACTOR NAME: f 1 l.L)Ri -Ty)c,. CONTRACTOR ADDRESS: STREET O 6c c ( )a • CITY 1 losx <,'t/r 1 U STATE a ZIP g?Z7 0 CONTRACTOR PHONE: LbA — 301— 1 s'S I CONTRACTOR EMAIL: -1/41:>tn C cwt.>1r se_Yv tus ct'e-Y-. CONTRACTOR LICENSE#(REQUIRED): AwR3-N_►.- 4. `j 10a- Kct CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 0 5-34a LI PRIMARY CONTACT: 0 OWNER rSCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (as--3co-) - -75 3-l 7 i v WI i.-7\._0 1,YA ry \ CONTACT EMAIL: -0>-N1/4J C"` G.L,i.)Y'Sege"L, ,Ls.5 • c.2„.s rrN, BUILDING PERMIT APPLICATION Existing Use of Building: ( 11(1.-Y-1 3 LA;..0 I0(IVLAI U('1 Contract Price of Work:$ 1-1 0C_a(% C,( Proposed Use of Building: ,)lc t vcu' & O VG..A1 01'1 Heat Source: ❑Gas ,[Electric DOther Building Type: ❑SFR-Detached OilSFR-Attached ❑Duplex ❑Multi-Family-#of Units: .Commercial Industrial Type of Project: ❑New DAddition El Remodel DRepair .C�.T.I. El Sign ❑Sprinkler DDemolition ❑Change of Use DESCRIPTION OF WORK: -rC.YlOA't-(. Svy, i't. �°t vh a n-� iv' e,x ,St-i�' b- •t c(i . UJ e yLc ,.h c.t ucte S (.).,,._s-lrvL#i en .-C i✓\}-e.r(o✓ vL,c�r1 oo.cn � b.ecLv( v wc�-llsi rtonl.occ`t L�Pur(+� ins�k�ivo�7 0 (�2�tk.�to✓ wash u.rud oralc�inl..,, R3v ".cul o,n 4o exisY1r� Celli. eLloove, work- aisc, ,+( ci 5 v2.r%ouc "Gnl{IuS/� c.ur`4er"eT(;� re.I-- .cfn l� LI ". -n✓� &Jaren sL(S$C in inked u)t -I-R. bu,tcetr�-Fire cae_rn-\ -sNS1e.rn . ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn Alteration Repair Type of Project: _t_New _- Addn ___Alterationp Re air #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures < Fixtures A/C-Air Handling Units Heat Pump t Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub r` Urinal Gas Piping Boiler E Lavatory(Was Basin) ` ,-- _ Drinking Fountain Water Heater Refrigeration 4 Shower <Cr Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer `'Medical Gas Range Hood I Water Heater Other: _ Exhaust Fan I Sink(Service/Bar/Mop/etc.) Other: SPRINKLER / SUPPRESSION SYSTEM _ Number of Heads 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT#_ . �/ / �� ti✓ CEJ?k'Ot( LLL.- R IAto \ g() ).--. .L5- 1 er/Authorized/A nt Signature Date (Revised 10/1Y/2015)