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PERMIT APPUCATIOI� <br /> /IP" BUILDING/ MECHANICAL i PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> - <br /> j _ CITY OF EVERETT PERMIT SERVICES <br /> ,eiffi3200 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 /> (Biue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:M26 ;✓" /2eij/,to .p/f9 &I'/i PROPERTY TAX#: °OH`1 m,0-0 it 0 07 <br /> LEGAL for new construction: Short Plat/subdivision if Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 0'0 Vk ter1 rt4L,L', LLC1 TENANT NAME(If Commercial): <br /> (1./O a.itc <br /> OWNER MAILING ADDRESS: STREET 9 6. t <br /> CnV Y VA k IV` e& STATE ifil�t'L,✓' ZIPS '''""`YYYY{{!!!!!! 792.0 <br /> OWNER PHONE: OWNER EMAIL: 666 <br /> CONTRACTOR NAME: - LJttyillte_, wr"iil',, ' <br /> ..,, _ <br /> CONTRACTOR ADDRESS: STREET ,' ( 8eAL <br /> CITY STATE 6,k- i ZIP ? 7 <br /> CONTRACTOR PHONE:x ''47 a/7 CONT CTOi3�EMAIL: C�1t j fed .I [ '�,CCDGA-. <br /> CONTRACTOR LICENSE#(REQUIRED):1(13 Ifl , CITY OF EVERETT BUSINESS LICENSE REQUIRED) 3r — <br /> �7 <br /> PRIMARY CONTACT: ❑OWNER 11TRACTOR 0 OTHER(Please Specify) <br /> C ACTN4 CONTACT PHONE: 0 r.. 76 x-/79/ <br /> % [ vt G:L CONTACT EMAIL: )9 t,,.Z/tel t4 a/"coo,C C' ° <br /> BUILDING PERMIT APPLICATION del Cl" <br /> DO <br /> Existing Use of Building: Z., izz Contract Price of Work:$ "ej Y.y 3 i OX.T <br /> Proposed Use of Building: i`vte..45("L.2.10-2100tis Heat Source: VGas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: RCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition36hange of Use <br /> DESCRIPTION OF WORK: l/ <br /> N _ - I <br /> MIA/U 4 I i UVIA V(kulc <br /> littki0 1 P 0 yii.:,310T6 <br /> ASSOCIATED BUILDING PERMIT#(if applicable). Jrl <br /> MECHANICAL PERMIT APPLICATION ` PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration _Repair Type of Project: _New _Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump / Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping BoilerLavatory(Wash Basin) Drinking Fountain <br /> Water Heater ( Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood 2k.4<------113:133`1121 Other: <br /> Exhaust Fan / Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Chemical or Water I (No.of Heads <br /> ACKNOWLEDGEMENT.t 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 - , ,, - e ate Contractors - - W and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PE <br /> ,.401 .��/./ , �. 6 -- 7/ / lT � o.„1, DO <br /> 0 nerlAuthoriz-i Ag#Signature Ddte (Revised 9/23/2016) <br />