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Apr 09 2017 02;18PM Washington Wat�r Mn�ters 8663757454 pag�1 <br /> i ii�� I <br /> PERMIT APPtIGATION <br /> BUELDING /MECHANICAL 1 PLUMBING /SIGN !SPRlNKLER! DEMOLITl�N <br /> CiTY OF EVERETT PERPAI'I'SERVICES <br /> 3200 CEDAR STREE"t',�VERETT,WA 98201 <br /> (P)425-257-8810 j FAX 425-257-8857 �(E)everettepsQovereltwa.gov� wrrw.everettwa.gov/permits <br /> (Blue or B!a¢k Ink Onl Please PROJECT SIT� i1VFORMATIQN <br /> PFtOJECT SITE ADQRESS: Z C`� �J�, PROPERTY 7AX#: �j ��''� w/� <br /> LEGAL for new oonstruction: Short Platlsubdfvision Lot No. �„ (attach copy of iong legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Q " TENANT NAME(If Commercial): <br /> OWNER MAlLING ADDRESS: srReEr � Ye <br /> cm �.�/ e si•nre � ziP Q�Z,O <br /> OWNER PH�NE: �%rt�� ' � "' � {;J� OWIVER EIVIAIL: <br /> CONTRACTOR NAME: uI A"S�I lUG7rTlJfU t�}-�-�i2. �--IG�}T��2�' <br /> CONTRAC70R ADDRESS: S7REET I�I�',�' Z �� �� �"l�'� '" G a� /G� <br /> CrtY '�I LiJ V/ I S7A'fG �/J LP <br /> CONTE2ACTOR PHONE: Z7"��" CONTRACTOR EMAIL: � � j}'ZI��Li L��YJ <br /> CQNTRAC70R LIGENSE#(R�QUERED): �i(J�J-CiF-� pl�U CITY OF EVERET7 BUSINESS LICENSE t�(REQUIRED�: ,3 <br /> PRlNkARY CONTAC7: p OWNER CONTRAC`COR ❑OTHER(Please Specify) <br /> CON ACT NkME� CONTAC7 PHONE: 2.. ��r' 3-7�l `7 <br /> \J�' ���I I� I 5 CONTACT EMAIL: G�1�}'LU/�'ff L�`f{-�(�/YII�}'�L,���� <br /> BUILDING PERMIT APPLICQTION <br /> Existin Use of Bulldin : ` � Cantract Price of Work:$ <br /> Proposed Use of Buildln : Heat Source: CIGas C1Electric DOther <br /> Building T e; CISFR-Detached ❑SFR-Attached �Duplex C1Multi-Famil -#of Units: C3Gommerclal ❑industrial <br /> T e o4Proect: ❑iVew ❑Additlon ❑Remodel ClRepair �T.l, ❑Sign E�Sprinkler ❑Demolition ❑Chan e of ilse <br /> DESCRIPTIdN OF WARK: ' <br /> 1�('�'�1�.�' '�- � �.�t�l G�CL I �,`� ti�l����' ����^ <br /> �� <br /> ASSOCIATED BUIL�ING PERMIT#(if a plicable: <br /> MECHANICA� PERMIT APPLICATION PLUMBtNC PERMIT APPLICATI�N <br /> 7ype of PI'oject: _New Addn AlYeration _Repair ,� Type of Project: �,New TAddn Altoration _Repalr <br /> #oi Llst of Fixtures ��f r�t f Fixtures #of �(st at Fixtures #°j Llsi of Flxtures <br /> Fixtures Flxtures Fixfures �fxtures <br /> A/C—Air Handling Units Heat Pump 7oilet Backflow Preventer(Inside Bid ) <br /> Forced Air S stems Un[t Heater Bathtub Urinal <br /> Gas pipin Boiler �avatory(Wash Basin) Drinkin Fountaln <br /> Waier Heater Refri eralion Shower Floor Drain <br /> Gas Fire lace Wood Stove Kit�hen Sink&Disposai Grease Tra <br /> Gas Ran e Ducting Dishwasher Roof Drains <br /> Clothes D er Hooku s O#her: Clothes Washer Medical Gas <br /> Range Hood Water�leater Other. <br /> ExhaustFan Sink(Service/8arlNEop/etc. Other: <br /> • SPRiNKL�R/SUPPR�SSION SYSTEM <br /> Number of Heads <br /> �1CKNpWLEDGEMEN'I'�I Irau�r�eviewed rhis appli�atfon artd confirm fhe informallon contah�ed herein is lrue and correct.iNork done pursuant to fhis permJt must comply wifh <br /> current federal,sfate,and local law. The q�anfinr�o.`a permlt only authonzes approved worlc and�io deviations fherelrom.Devlations rnusf firsl be authorrzed 1n wdting from lhe <br /> Buildinc�Of�cial before being auth,orized unrier nny circurnstance.1 am fhe owner,or I am a�!hor?zedl�y7l�e owner of thFs pro�erfy to pe,�fo�m the work for whlch a pylication is made, <br /> and i corr.pJy wilh the S1ate Contr3clors L�w 18.27 RCW and 296,200A WAC. <br /> City ol Everefr Of(kla�Use Only <br /> ���'� � •� / � ( PERMI ��r V� <br /> ,��p �� <br /> Ownor(AuEhorized pent Signa i e Dafe (Revlsod 5/70/2Di6J <br />