|
PERMIT,r4P�'LlCA,710 .
<br /> �LJ1LD1�N`lECH/�NICAL!PLUMIBiIVG !�iG�! ' RIl\IhCL.�R I DEIUIOL.I7'(CJN
<br /> CITY OF EV�RETT PERMIT SERVI
<br /> 3200 CEDAR STREET,�VERETT,WA 98201
<br /> (P)425-257-8810 � FAX�125-257-8857 �(E)everef#eps@everettwa.gov� www.everetfwa.gov/permits
<br /> _ ... ___.._._ - ::.•,:_ :�•-:::.:.., .. .•s:_ s.:_::...;.;.:�_�-.•-. .,_. ___,.�.• - -- - - _ - _ - - _-
<br /> • _.. . ..._ . ... :•.t.^..::;_^;..-•::..- .._. .� �.:.t .. . .. . - -- .xJ�•'.-i`ixii�.
<br /> ..u.._.•.•.-.z..e r.f a:��i:"�.'•'.i'i;::,'�::�:r^-:.�s.`::
<br /> ..�a_•�..:""s.�-.::�:c.�;;;�...:__i.:-..:.�t:s,. .r•.:,_ .�..._u., n . . _
<br /> . ._. ..o.. ;r.�- ...z rrs�.. .__ .-..:.`-;_.^.+.:._.c..-_ ob..:u.;-�..s. '��'..: '�•.S Y u ....� �aR�d�1=?IO�Ni'�>?'a'�,'t��:"t;=j��`:,::`-1,-..;,�=�::`•`:��ai;:w.'.;'.;:.,M+.•.:.
<br /> •..�..:.5__ii•�3`t^":_:.i..:..��Sr:F"..:". > .iS:: _ _ ..h...���, - - _ '
<br /> :-:::":�}'.•
<br /> :-.��.-_,�.:.��_z:,•.r:.. :.. ....�:._.-��:•:•.�:::._�:.:-:_:<�.:.:.•,::.....:_���!f�0.7EE _.�s.:._,. �..__ ._. .r::._•:••-• . . :-:•
<br /> �pROJECT SIT�ADDRESS: ��� -I Jo7�h ST<S� PRflPER7Y 7`AX#: ��9 . .^ nU�l(���
<br /> L.EGAL for new consfruGfion: Short Piaf/subdivision Lot No. (attach copy of Iong legal descriptian)
<br /> .;L, _ _ •,,�•., �,.r - _ r;�•:::,::._ ;,� _ - -.•.�; : • , .
<br /> ^-�.-.. �.... �kse.r,_.. .. .. .. .�...., s :..••.c..S,-� _ "r� .. . ' '
<br /> .. ..._.._:'c:.:: ...�.T..:.: o�x.•... .. ..�^.��r,1+' :p 5J :�1" •!:"
<br /> .,..., r. �.a3 ��a�SE..ajs.:'.�.:••i_••.c. �I,..:•_.�. .i •'. �.0�'n.{' ' '
<br /> _ .�, .,.. �;�Ol±f'i"Atrr"f'�INf�i�Nl�iT.,. .;;�,_.:�
<br /> .._..�.::::;..,<_._�: -n��•l..� r:=r::��.:�.��:�����t:����...:.:::;�..�-.::.: �'�"�-� -
<br /> c•;::_::•..::...;e:.:.=:.t:• .,:...F.: .,..• .:. . �_..�:,r:.•a.:,,.._. :. �... . .:e..{ .�, . .. ... ...... •• .� •'�~'.�:':- . .
<br /> UWN�R NAME: $!L � � V T�NAN7'NAM�(Ifi Cammercial); �� C
<br /> OWN�R MAILING AADRESS: srR�r �gI(O- �'� c5 S� •
<br /> CITY �
<br /> STATE W7'—i � ���U
<br /> OWNER PHQNE: OWNER EMAIL:
<br /> CONTRACTOR NA11�t�: dUS J
<br /> CONTRAC7QR ADDR�SS: s�rtEer �j l.! /J T �'i ^��
<br /> CIIY f✓ STATE W� ZIP ��OU"r T
<br /> GONTRACTOR PHONE: L��= / - �I D CONTRAC?OR EMAIL: �J/�� I1�1$ .N A � �
<br /> CONTRACTQR LlCENSE#(REQUIRED): C13Y OF EVERETT BUSINESS LICEPISE#(REGtU�RED): D�JS�
<br /> PRlMARY CONTACT: ❑OWNER �'CONTRACTOR ❑O R(Please Specify} •
<br /> CONTACT NAME: Tj�(S,7"Gj�S�C�bo2 Q� CONTACT PHONE: �o�S� �/�-
<br /> G�(0 ��D MCS W`� CONTACT EMAIL: C'T1�MS U/� � rNs I C3
<br /> "'.__. ...... ._ .,_.,..... .:_�..>-cd_•,�-<:.--,.__>-.�vNs��. r-r.-�e._:_•_—��. ' .. _ -_> _ ' " _' " ' - .
<br /> _ .... ._..�_ :_• �a_•._ •_._�_�a-......�cvi.., n`:5..�• »_ � . . .s_ .� :.' ..p.'r'' _ y �'�i"i,`��•�'•'.'F.�..'��`_'__ _ ==1_�'.'F 1%J:
<br /> _ _ __-_ _<.,:�.,.�z�^___ _ _ -3•,r..:t:.e�i:.�" ' �� ':�PLr•�r.'�C�T�IQ�.+'.�`L• -t.'i"::'.Y-_.v
<br /> _-�.-_=�.;=:-=�*b �._ _- - _ .�_::BU_ILbaN;C�s;PE.RJ1��.� ._------�--•-- --- : _�:•-:: ..� .,.
<br /> -�::. -.-�_,=-=-'
<br /> .. ...-� ..�_;-: �
<br /> . ..:�. � -
<br /> .._ �
<br /> �_:s:-':-.."`:•...;�_3? '{' "_"ve�.. �.v'5:.3-• ��°2.::t.5}'��:a.: ..._. . .._ .. . .... . . �
<br /> - ` pTo
<br /> Fxisfing Use of Bu�lding: S /(�!v � Gontract Price of Work:$ � i 5� '
<br /> Proposed Use of Building: � �� Heat Source: C1Gas ClElectric L70ther
<br /> Baiiding Type: ❑SFR-Detached T�1SFR Af#ached C1DuRlex CIMuJfii-Family-#of Units: [�C4mmarcial Cltndustriai
<br /> Type,of Projeaf: �New ClAdditipn �Remodel I�Repair L77.1. C7Sign L7Sprir�kier C1Pemolitian J�Change of Us�
<br /> DESCRlPTION OF WORK: ����cC �y��Srt1�G, �'Q-�5 i�q-No�ti(;�, S�G N �N � ,� I�STA�� N�
<br /> ���ESTAr�v�n�C-� SiGN �'J.1a� . (JO Ch�AN�j'j� �v ��►S`i"IN� W�l.l� S��3NS--
<br /> ASSOCIATED BUILDING PERMIT#(ifi applicable):
<br /> :z�.,1Y;:._. r �.��• �: � �- ' '�• ' _ ':�P:LC��'1��.P�RIf�I'f'•:A�P��.I�A'TIfl�N. . .
<br /> "�. -.;,I�1,E�HA1i�I�A�.:.;tP�E;RMYT�1'�AL7ti�f,'�1�O�191_3=..,�.:'�: :.,...•.:.. . ..,._. _ � . .. . -. -.
<br /> .. ,:.. •.. _.. . _.. �.. .. . .
<br /> 3ype of Project: _New_ Addn .,_��Aiterafion _Repair Type of Project: _New Addn Alferation _Repair
<br /> #of List of Fixfures #°f � List of�xtures
<br /> List of Fixtures ��f List of Fixtures #of F��ures
<br /> Fixtures Ftxtures Fixf�res
<br /> A/E-Air Handling Units Hea#Pump Tqilet �ackflaw Preventer(lnside Bfdg)
<br /> For�ed Air Sy�tems Unifi Nsater � Bath#ub � Urinal
<br /> Gas Pipfig Soiler Lavafory(Wash Basin) Drinking�auntain
<br /> Wafer Heater Refrigeration Shower F�oor Drain.
<br /> Gas Firep(ace Wood Stove Ktchen Sink&Disposal Grease Trap
<br /> Gas f2ange Ducting Dishwasher Roof Drains
<br /> Clothes Dryer Hook�ps Other. Clothes Washer Medical Gas
<br /> Range Hood Water Heater Ofher.
<br /> Fxhausf Fan Sink(Seroicel�ar/Mop/etc.) Other.
<br /> �:: ....: � ..... � ,•= •
<br /> .. .. . .._. . -
<br /> -: •-•_
<br /> .._:__..
<br /> .. �.�.:SPRiNKLE,>;I.�UP:P:RLS:,S,10'�(�S1t'S7,';ENtn`_`_:'-:�-
<br /> :: ,.;::.:...��. .. ,�,..,_ .,.,._ ,,.:;.:_.,_ ... . . , . .. . .
<br /> Number of Heads
<br /> ACKNOWLEDG�MENT.1 have revi.�wed this applicatioR and confirm the information contained herein is true and correct Work done pursuant to#his permit must comply wiEh
<br /> currenf federal,sfate,and loca!!aw The gra»ting of a permif on/y authorizss approved work and no deviations therefrom 1Jeviations must frrst be authorized in writing from fhe
<br /> BuildingOffioial before being authorized under any eircumstance.!am the owner,or l am authorized ky the owner of this property fo perfo�m the work for which appCrcation is made,
<br /> and 1 cnmply with the State Contracfars Law 98.27 RCW and 2sS.2ooA WAC Cify of Everett O�cial Use Only
<br /> PERMIT# ���
<br /> �-- p�3-03�b 1�,
<br /> Owner/Authorized Agent S�gnatu�e ua�e (Revised 10/92/2095)
<br /> \ �
<br /> ��
<br />
|