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Jut 26 2017 10,35AM WashingtAn Wate�aters 8663757454 page <br /> PERMIT AF'PLtCATIQN <br /> BUILDING/MECHANiCAL 1 PLUMBING!StGN 1 SPRINKLER I DEMOL1TlON <br /> C1TY OF EVERETT PERMIT SERVtCES <br /> 3204 CEDAf2 S7REET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX a25-257-8857 �(E)everetteps�avarettwa.gov j www.everettwa.govlpermits <br /> (Btue or Blaak I�k Only Pl�ase PROJ�CT SITB INFORMATfON <br /> t'ROJEC'Y S4T�AI3DFtESS; �G� ' � PROPERTY TAX#: � 7� �YJII� <br /> LEGAL for new constructimt: Short PIBVsubdtvislon Lo:No, (at#�copy ot long legal desciipUon) <br /> . ....... <br /> �cr r�r�arc�arar�v�r --------- <br /> OWNER NAME: � TENANT NAME(if Commerctal): �^ <br /> OWNER MAILING ADt7RE5S: S7REET f � � <br /> � CI7Y 'f/"�✓`' l..��/ 8'ATE t/`� � AP �� <br /> OWMER PHON6: ' .�j �` OWNER EMAIL: <br /> CONTRACTORNANIE: ��1"[�NVl�N /�' � ����� <br /> CONTRACTOR ADaRE55: STREET j ` G �� /� <br /> Cryy ���[f� STA7E �� ZiP <br /> CON7RACTOR PHONE: Z�r��" � CONTR,ACTOR EIVtAIL: Y` /�'dl�1 Li C(fj't',� <br /> CONTRACTOR LICENSE#tR�QUIRED): �r(,J � Q�� CI'FY OF EVERETT BUSINB5S L.ICENSE#(REQUiREDj: � <br /> PRiMARY CON7ACT; ❑DWNEFt CONTRACTOR �QTH�R(please Specify) <br /> GON ACT N,�ME� . CONTACT PHONE: '�..�� 3—C��{`rI <br /> �,Jr1�C.1 �L�.P1��l,S CON7AC7 EMAIL: W�t1�-ti�i�C.@ E A`G�L.C!� <br /> BUI ING PERMIT APPLICATION <br /> �xistin Use of Buildi : Cvnfract Price of Wvrk:$ �Q� <br /> Pro osed Use of in : Heat Source: ��as I�Electric �Qther <br /> Buildin T pe: -Detached ❑SFR-Attached ❑Du �x C}Multi-F'amil #of Units: L7Commercia! ❑Industrfal <br /> 7 e of Pro'ect: C1New ❑Addition C]Remodel OR air ❑T,I. ClSi n ❑5prinWer l7Demolition C]Chan e of Use <br /> DESCFtIpYlON QF WOR1t: <br /> �?�1v1,.0 I^--� �-.-��G�-�`.�- f -�,� �"��i (�,1G��..�' a.,�f�i' <br /> ASS�CtATEa 9UIL,DtHG�ERMIT�l(if a licabie : <br /> M�CHANICAL PERMIT APPLIGATIdN PLUMBING PERMIY APPLICEITEON <br /> Type of ProJect: _New Addn _Alferatian �Repair Type of ProJect: M1lew ,_Addn Alteration _Repair <br /> #of �,�st of F�xtures #�t L1sf of Frxtures �°� lisf ai Fixtures #°f llst od F'rxtures <br /> Rxtures Ftxtures Fixtures Flxturea <br /> A/C—Air Handlin Units Heat Pump Toilet Badtftow f�rerrenter(inside Bldg) <br /> Forc�ed Air S stems Unit Heater Bathtub Urinal <br /> Gas Piping Bofler Lavato (Wash Sasin) Drinkin Fauntain <br /> Water Heater Ftefrigeration Shower Floor Drain <br /> Gas Firsp3ace Waod Stove Kitchen 51nk&Disposal Grease Tra <br /> Gas Range Ducting �istnvasher Roaf Drains <br /> Clothes Dryer Ftoakups Other: Clothes Washer Medicai Gas <br /> Ran e Hoot3 Water Heater Other: <br /> F�chaust Pan Sink ServicelBadMo /elc. Other: <br /> • SPRINKL�R t SUPPRL°SSION SYSTEM <br /> umBer of Heads <br /> ACKN�IM_EDGEMENf•!lravetevlewed this applrceFion and c�enfi�m fhe informatfon conlalrted hera�n is dve and carrecL Work dare pursuant to thls permif must comply vyith <br /> curren!lader�l,slsfe,and locaJ lew.The granting of e pe»nit only aothorizes approved wor/t and no dev�aHons fherefrom.Devletbns musf F(rst be authorked in wrffing nom the <br /> t��lldlnp OfNclel hefore being authariz�d undor any umstance,t am Nra owner,ort am autharized by tfrs owner of thfs praperty to paNam the wo�k for which appAcatTon is made, <br /> a comply withlhe 3tate Conrracla►s aw i8.2/ W erfd 286.2�A WRG. <br /> Cily olEveretf d/llclal Use�nfy <br /> �l �z�- pE _ <br /> t7 � ��o�- �f <br /> 0 fAuthorized Agent 5fqnature �ate (Revlsec15�20l2096} <br />