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Feb 1417 03:01 p Bart Olson '�r�357-5985 p.1 <br /> PERMIT APPL[CATION <br /> BUfLDING/MEG�iANiCAL 1 PL�iMBIMG 1 SIGN!SPRlNKLER! [3EIiVI�LITION <br /> CITY OF EVEREI`T PERMIT SERVICES <br /> 32U0 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 j FAX 425-257-8857 �(E}evereiteps@eueretiwa:gov� www.everettwa.gov/permits <br /> (Blue or Btack Ink Only Pleas PRO,IECT ITE NF ATI�N <br /> PROJECT SITE,4DDRESS: . � � (, , PF�OPERTY TAX#: d � �J � � . �U <br /> LEGAL tor new wnstruction: Short P�aUsubdivisio Lot No. (aitach copy of long legal desaiption) <br /> CONTACT INFORb�ATEON <br /> OWNER F{AME: ,��� TENANT NAME(If Commerciat): <br /> OWiJER MAILING ADDR�SS: srReEr , , + <br /> cm- �"f' � STATE P <br /> OWNERPHONE: 7 ` OWNEREMAIL: �� r � , �f�' /Z f � <br /> CaNTRACTOR NAME: <br /> COPETRACT�R ADDRESS: snxesr <br /> Cm" STA7E ZIP <br /> COPlTRACTOR PHONE: CONTRACT012 EMAIL. <br /> GONTFZI4CTOR LICENSE#{REQUIREt�): CITY OF EVERETT BUSFNESS LICEN3E i!(�2EqUIRED}: <br /> PRiMARY CONTAGT: ❑OWNER O CONTRAC�OR �],OTHER(Ptease Specify) <br /> CON'fAC7 NAME: CQNTACT PHONE: � ` �'�'� <br /> � �'�W� CONTACT Eii1A1L• , •'�� ,n � � <br /> BUILDING PERMlT APPLICA N <br /> Existing Use of Buildi - ` Contract Price of rk:$ <br /> Pro osed Use of 6uildin : �. t�teaf Source: �G ❑Electric er <br /> B�eilding T pe: ❑SFR-Detached ❑SFR-Attached u lex I�Multi-�amiE of Units: ❑Commeraal ❑industrial <br /> T of Pra'ec� �New ❑Addition ❑RemodeR -. e alr ' C7l:i."--`.OSf n`"'QS rinkler �Demolition E�Chan e of Use <br /> D�SCREPTI QF WQRK: <br /> ���Uv �'� ����i ��� �` , ���� �r'� (� 1 ��0� . �`� ����j ��2��f� . �1�,. <br /> ' � . . �� �1�^ �i�! - - �c�l'� �'� ,��,�f�. <br /> AS50CIATEO BUILDlA1G PERMIT# if a bcabls: � � �� " <br /> MECHANICAi.PERMIT APPLICATlON PLUMBING PERMIT APPLfCATfON <br /> Type of ProJect: ,New _ Addn AlteraQon �Repair Type ai ProJec1: �New �Addn _Altera8on `Repair <br /> Ffxtures ��t of tixtures ���5 List of Frxtures #of ,�,ist of�ixtures #of uy-�a f Ffxtures <br /> Flxtures Fix[ures <br /> AIC—Air Handlin llnfts tieat Pum Toiiet � Backflow Pr�eventer(Inside B!d ) <br /> Foroed Air S ster�s Unit Heater 8athtub Urinal <br /> Gas Pi�in Boiler Lavatory(Wash Basln Drinking Fountain <br /> Water Fieater Refrigeration Shower Floor i7rain <br /> Gas Fireplace Wood Staue Kitchen Sink 8 Dis osal Grease Trap <br /> Gas Range �ucYin Dishwasher Roof Drains <br /> qot.hes Dryer Hoakups Other: Clothes Washer Medical Gas <br /> RaR e Hood Water Heater Other: <br /> Exhavst Fan Sirtk 5erviceJBar/Mo /etc. Other: <br /> SPRIHKLER/SUPPRESSlON SYST�M_..`__:_ _ ,:_ _._... __ _ ___ <br /> Chemical or Waier Ko.of Heacls <br /> ACKNOWLEDGEMEN?'-1 have reviawed this epy/ication and confirm the lMormafTon contairted he�ein is true and carecL Wotk done pNrsuant to this pemv/t must cornply with <br /> cumant�ederal,stale,and locallaw:The granl/ng of a permlt only authorizes approved work and no devlafions therefrom.Devlaflor�s musi Flrst be auihorized in wnlrrtg from lhe <br /> Sui1ding CiTicfa!befare being authoriaed underany eircumslanco-1 am the owner,ar I am authorized by the owner of this prnperty io per(am the wo�k for which applicaUon is made, <br /> and 1 oomp�y wiih fhe Stata Contract rs Law 98.27 RCW and 296.2QOA WAC. <br /> � Clty of Everett Orfrc/aJ Use Only <br /> � �� � � P !T#��� � � <br /> OwnerlAuEhuriaed Agent Signaturs ate (Revise 9/23l2076) <br />