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� ,,:, �W�.;. <br /> ,, . , �:�� <br /> s ���. <br /> �� <br /> � PERMIT APPLiCATiQN <br /> �:� <br /> � $UILDII+fG i M€CHANICA'L i'PLUMBFNG!SIGN !SPFtINKLER/DEMOLITION <br /> �. : C►l'Y OF EVERETT PERh11T SERVIGES <br /> 3200 CEDAR S7REET,EVERETT,WA 9820�1 <br /> (P}42b-257-881d j FAX 425-257-&857 �{Ej eversttepst7evereriw�.gov� www.ev�rethua goutpermiis <br /> {�3#ue or Biac�C Ink Ot�l Piease} � � PRU«�EC'T'SITE �NFC#1tMAT[t?N <br /> PROJEG7 SITE AITDRESS: 1� j � ^ : .�/•�.._ PROFEF2TY TAX#: <br /> LEGAL for new construc6an: Short PlaUsubdivision Lot No. (attach copy of long legai descnptian) <br /> CONTACT INFORMATlON_ <br /> � , _ <br /> dWNER NAfiAE: � � � �, {' �y TENANT NAME(if Commerciat): <br /> ;:� <br /> OWNER MAILtNG ADDI2ESS: s�eer Z� . � �,',� V <br /> � <br /> CITY ,�-�"� SYATE ` ZIP '�(� � <br /> �� awNEra P�or��: � 2,�' �.� � ;.._ � owr��R�nnqi�.;, ���, �v����� e� � t��t( , <br /> �x' G4NTRAC70R NAME; :,���` <br /> �: <br /> ''y COIdTRAG30F2 ADDRESS: srR�t <br /> arr srara zie <br /> _---_..� <br /> �.� CONTRACTl3RPNONE: GONTRACTOREMAIL: _ ,,, <br /> CONTRACTt7Ft LtGENSE#(RECttIiRED}: CtTY OF EVERE'FT BUSINESS UCEidSE#(FtEQU4l2ED); ;' <br /> PRIMARY CONTACT; f3WNER L7 GONTRAGTOR ❑QTHER{Piease Specify) <br /> -____—_ <br /> CQNTACT NAME; _. CONTAGT PHONE:(t.�'�.� �'� ._ c{ <br /> ,� �,`',� �-'��� GONTACT EMAIL: `�..'� Crr'c) cJ <br /> , <br /> z'-`:��' �...(`-� {Y���t � �� <br /> BUILDlNG PERMIT APRLiCAT�'bN� � � <br /> =' Existin lJse of Buildin : ;a �e� ContraCt Price of Work:� � C{-'�" i <br /> ' Proposed Use of Buildin : - Heat Saurce:� ❑Gas C�Electrie C10ther <br /> � <br /> '�� Bui�din T �: C�SFR-L�eCs�hed GISFR-�-1Bached ❑Du iex ❑Muiti-Famil �of Unifs. Q�ommerciai ❑Industrial <br /> � T af Pro ect: ew C1Addition QRemodel Re air �T.I. ❑Si n ❑S rinkler ❑Demo{itian �Cha� s af Use <br /> DESCRIPTION OF WQRK: <br /> —�'c..��1GLLi`(l 4'`CAy"� i v'� VY\Lt.S�t�✓ {�Gt�'1 ti fJZ>t^t� <br /> " {Z-e�l G C; ��c.f- t,�n.'� �r"G,-v� t'4^Q. �Cz v� -f-� -=r h 2_ f7 v'}S:��-C <br /> " ib1S�--t�.11���� c�;, v1��1 :'c?v�-' C.:r,�'� <br /> ASSOCIATED BUI�+DING PERMfT# if a 6cabfe : <br /> ,�, MECIiANICA� RERMIT APPLICATION PLUMBiNti PERMIT APPLiCATf�3N , <br /> �< <br /> Type of Project: ,j�New Addn Alteration �,Repair Type of Pro)ect: New Addn Afteration Repair <br /> #of uy.�ot Fixtures #�f List af FixtUres �Qf List of Fixfures #of ust of Fixtures <br /> Fixtures Fi�ctures �lxiures Ffxtures <br /> AtG—Air Mandiin Units Heat Pump'` Tcrilet`' Baekfiow Preventer Inside Bld j <br /> �orced Air S stems IJnit Heater Sathtub Urinal <br /> Gas Pi`in Boiler` ' Lavatory{Wash Sasin) Drinkin Fountain <br /> Water Fieater F�efn erafion �hower F(t�or t��ain <br /> Gas Fireplace Wood Stove Kifchen Sink&Risp�sal �rease Trap <br /> 6as Ran e : Duc6rt E�ishwasher R�ofi Drains <br /> <. CEothes Qryer Hocskups Qther. • Glothes Washer Medica!Gas <br /> Ran e Hood Water Heater Other: <br /> a: <br /> 4 Exhaust Fan Sink ServicelBar/h/Eop/etc. Qther: <br /> ,� � <br /> SPR#NKI,ER1 SUPi�R�5510N SY$''t'EM' <br /> Chemicai or Water No.of Heads <br /> ACKNOWLEDGEMENT:!have reviewed this application and confirm the rnfprmation contained herern is hue and correct. Wak done pursuant to this permit musf compJy with <br /> cutrent federal,stale,and IocaJ lawr. The granting of a permit onty authorizes approvec!work and no deviations iherefrom.Deviatrons must frrsY be authonzed ia wrrting�rom fhe <br /> ' Buildrng Otficia!beiore being aufhorized under any circumsfance.!am the owner,or J am authorized by the awner of fhis property to perform Yhe work for which application is made, <br /> and!comply wrfh ihe State Contractors Law 18.27 RCW and 296.2a0A WAC. <br /> City of Everett Offrcra!Use On/y <br /> .�--- a � z �� �ER��� �1-� �� - ��-{ <br /> O uthorized Agent Signat Dat (Revised 9/23/209fiJ <br />