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PERMIT APPLICATION
<br /> JILDING i MECHANICAL I PLUMBING I SIGN I SPRINKLER I DEMOLITION
<br /> CITY OF EVERETT PERMIT SERVICES
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<br /> 32 0 ‘:.-.EDAR SIREET,EVERETT,'iVA 98201
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<br /> (f ,4 23-207-.381Z 1 PAX 425-:57-8657 l(L)eaereiteps@everedwa gov l www.eaereftaaa,gov;permas
<br /> 10.111.141.1.....,40014,,..,X,WM A....41.4.1-1.6.61.11610.1W04.01140.111111011.WIIMMI14100010.
<br /> Blue or Black ink Only Pleaoe) PROJECT SITE INFCIRMATION
<br /> WIP0101....MililINI*4,11.......1.14 .51. 1.11.4110IMMW111WWWW/W,.... arourvimaspromfor*W
<br /> PROJECT SITE ADDKESS L-4-,..c,\,,..„ \\\I„()X- ,.....D kt,,,_
<br /> I- ti....e \ -, PROPERTY TAX 0: ,
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<br /> LEGAL for nr.av 0:ne l',. Ao,-- Filt,an rlia:; :olvi'ar>a _______ ____LT:No. (attach copy of long lege ria$cr,pt-L-')
<br /> ' ION 04,110.0N6WIIPNIMOVINIP 011,110•42.01.10.11.0.1.01*****1.50".01011.11.1.0•1051Mellatalliq ....,.„,,,,,„,,,,,a,,,,,,,,,,:,,,,....,,,,,,,,,,,, , /
<br /> COtITACT INFORMATION :
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<br /> OWNER NAME lk„I„ *Irkfli.i...1' TENANT NAME(V Commercial): < .
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<br /> !OWNER MAI.II..3 AirRESS: StEllE.E- II -' i •
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<br /> :OWNER PHONE: OWNER EMAIL:
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<br /> !CONTRACTOR NAME LA'CC\ —
<br /> ,CONTRACTOR ADDRESS: irRi•ET 1100 1 11Vb P1 t4r, ,
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<br /> Pr f k.21 r k.I(7)rICI STATE .i.,...1
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<br /> CONTRACTOR PHONE:42S -. ./!--...L.34-141,4/ CONTRACTOR EMAIL:fl e
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<br /> CONTRACTOR LICEIf SE#fRECtiliffi:Er, pi tar ij i Li S?-1,7,ry,,,, CITY OF EVERETT BUSINESS uceNsE o(RECILH' 1)): • d
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<br /> PRIMARY OCiNTACI: r.2 OWNER ...:::,:(2...2,ACTOP. C OTHER(P ease Specify)
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<br /> I CONTACT NAME r.s,.4:1(.0,e, C avri 00e‘\ CONTACT PHONE:"....42 ..
<br /> CONTACT EMAIL:k..,,,c i 1 le t-I(..),(4,1
<br /> :. riP1.1.416.101.414.11........1.3.,,..,‘0.1.0.1,frtWt.IINII.AOION,P9.1k..../..I.'ig................."........................................•k•A•MM '
<br /> WI LOIPIE PERM'T APPLICATION --------:— ----------
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<br /> 1.011.1.411.1.1.111•11111.1b1.11.111.......1111110.111111111111*S.111161.1111111.16M,
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<br /> Triorivim,1,,J.:La.,or E,:i ,L1.) 'R 9 c..c. !
<br /> .. Q......aislicthal, Contract Price 0- ork:S __
<br /> FroposaO tiSti ta Baabg -._ N 2)
<br /> Heat Souroe; *Jr ,
<br /> Buildup Tyna..„.41.3FR-De:tactied :-.IfiPPt-As,ajitill,.. CiMulti-Fam ty.:_tf of Units: (,ommerual °industrial 4
<br /> ORepai: 0T.I. 0Sign CISonnloer El tarriotad Mchange of Use
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<br /> ESCRIPTION
<br /> D OF WORK:kr,ss,1/4.0.‘‘ c.,,Th„ ,,,..
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<br /> 11ASSOCIATEC E ill.C.NG PERMIT ff :k aptsicable°
<br /> MECHANICAL PERMIT APPLICATION 'PLUMIIIIQG PERMIT APPLICATi014
<br /> I., ,11.10.1111.0.11.1111.81,11116.0101MISMIN..80 moseirailmaimmusisadi, 41•Wle IIWYOOMNISNIIM•af•MNNPIIINMIMMWPI.Mlt**0..I.MIW.I.Wa... .
<br /> iype of P•c..iject: New Addn iteration Repair Type of r.ojec.t.: New Addr Alteration _ Rep,w
<br /> I , , i_ Lsr of,ixtures Li$t of Fixtures List of Fixtures
<br /> ; rrer;'ures F..ja_r_ 1 List of Fixlares Firwres
<br /> Fixtures . • 1
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<br /> .Pq.C.-Aii FiZir Ci Iwo Utah; HIFr Toilet Bac-idiom.Preventer(Inside Slo3f
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<br /> ' -Otte]Air I,yS, ITIS Unr:Heater
<br /> Bathtub Ur nal
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<br /> .,,;a3 Ploi"1 BoAfar Lavato (Wash Basin) Da oking Fointain
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<br /> , Water 1-uttfer Refit eradon NM Shower Floor Drain . .
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<br /> .'3‘tova,.. 1111111111Ktchen link&Disposal , Gfease Trap
<br /> hZ;aia.f.Par):)e Ducting Dishwasher Roof Drains •
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<br /> ,..:InthE 3 Li-a,it Hookups Other Clothes Wasner Medical Gas
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<br /> Watef Heater0 ler:
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<br /> a ' SatfaLst F'ar;
<br /> Snk .Service/Barglopietc.1 ,-,„
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<br /> ,rerse....won.. ou........0400146.04.6.1111.1.......4404 ....."....• ........
<br /> SPRINKLER/SUPPRESSION SYSTEM
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<br /> ACK IV 0 NL•::--.t,,,:iii"Pi L:f,"'” i'IWO nWIPti,"ell."`M.*:paCal/CH WIC co'Atm the Ili wr->ation canto-tad hetsisin t Vara ac correct Nor*tik:On.pL::..,r,... 'r'.th:s pelral nest comp*with
<br /> freolt fedora".rtone,old-d:dfl,e.v. rr,t,grantelo of a permit or:1y euttorues approved wars enc no deem/ens?e-efrom Deviations mar'• :.• ,sethorrited al*mane itom the
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<br /> Sviiem OrPc.'af Warp*slap out°Azad sale,-sr,"dwaairistaapa. i orb lire°Amor,or I am atitortztO by the amber sl`nis property to W*1":4'''r"'''' ''' h'v whkh apP,vation is mace, •
<br /> 1 ana":‘,orrielp we Ire,,,!ate Confrecois...a v 1F.2.1 KW and 246.2i;t0.4 tel,Af;:.
<br /> Cify at f'rfrott,:abriar Use On4, :
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<br /> -..}41_ PERa#,
<br /> ,.. 0. rkfr,'-uthorixoti Award Signa.o4u Date :Revisor(9/23/2016;
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