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/filliPPERMIT APPLICATION <br /> BUILDING / MECHANICAL/PLUMBING /SIGN I SPRINKLER 1 DEMOLITION <br /> .7" CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 i FAX 425-257-8857 I(E)everetteps evereftwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2720 Rvc,Ke..lr PROPERTY TAX#: <br /> LEGAL for new construction: Short PlaUsubdivlstrin Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: • ra - TENANT NAME(If Commercial); <br /> OWNER MAILING ADDRESS: STREET 27n fRU ee, <br /> CII, 8)er-ett STATE I.00- ,,,q8 201 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: CM titi.-►"S1117L <br /> CONTRACTOR ADDRESS: STREET 1%46(' ^Y"2QC)u c � <br /> (: ty�`._e`7r, ek ��4STATE AZIP (:)/ <br /> ( A?2,0 <br /> CONTRACTOR PHONE:L ?5 ase 05–"DOCONTRACTOR EMAIL: d ;, l e., !ja`tGcleyol 'anvil • (Om <br /> CONTRACTOR LICENSE#(RFOUIRED):CMVita Iril,t4 -71.d fl CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): I(laelq <br /> PRIMARY CONTACT: 0 OWNER (S CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: 7CONTACT PHONE: asv CONTACT EMAIL: deb b;e pc"kejnC ,?rn <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ Cf,q..20•0 0 <br /> Proposed Use of Building: Heat Source: ❑Gas gflectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units:, Conmerclal ❑Industrial <br /> Type of Project: ❑New DAddition ❑Remodel ❑Repair DTI. OSign ❑prinkter ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> RePlpc� car handler. moi- hes+ Puw <br /> ASSOCIATED BUILDING PERMIT it(it applicable)` <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATT <br /> Type of Project: New _ Addn _Alteration _Repair Type of Project: New _Addn Alte on _Repair <br /> #of List of Fixtures #of <br /> #of <br /> Fixtures Fixtures List of Fixtures List of Fixtures #of List of Fixtures <br /> Fixtures <br /> Flxtur <br /> NC–Air Handling Units / Heat Pump Toilet Backflow Prevente_(Ina, jr. ) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler `Lavatory(Wash Basin Drinking Fountain <br /> Water Heater Refrigeration Shower WFloor Drain <br /> Gas Fireplace Wood Stove 'Kitchen Sink& posai Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes asher Medical Gas <br /> Range Hood Wattf eater Other: <br /> Exhaust Fan SigYt(Service/Bar/Mop/etc. Other: <br /> SPRINKLER I SUPPRESSION SYSTEM G/ <br /> JChemicai or Water 1 No,of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the Informati n contained herein is true end 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use OtiA <br /> +, 3.1 <br /> � <br /> lb . 17 <br /> tt(PERM T 0 —oQ(, 0 <br /> �y <br /> 'Ovine/Authorized Agen igna�5 Date (Rent ad 23/2016) <br /> (-ix <br />