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PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:76Z� EVeI'gl"@eil W2y PROPERTY TAX#: <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: PI8C1@t FlttleSS TENANT NAME(If Commercial): �+�i��i��� �,`���� <br /> OWNER MAILING ADDRESS: srneeT 7621 Evergreen Way <br /> �„�Everett STA7E WA ziP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: B@I'1')/Slgll SySt2fT1S <br /> CONTRACTOR ADDRESS: srREET 7400 Hardeson Rd <br /> cirv Everett STATE WA ziP 98203 <br /> CONTRACTOR PHONE: 425.776.8835x114 CONTRACTOR EMAIL: tracies ber si ns stems.com <br /> CONTRACTOR LICENSE#(REQUIRED): bef�/SS857b7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):OL47H6 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.776.8835 X114 <br /> Tracie Skiles CONTACT EMAIL:tracies@berrysystems.com <br /> BUILDING PERMIT APPLICATION <br /> Existin Use of Building: Contract Price of Work:$34,916.00 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> T pe of Pro'ect: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. QlSign ❑Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> install 2 wall signs <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn _Alteration _Repair Type of Project: New _Addn _Alteration Repair <br /> #of ��st of Fixtures #of ��st of Fixtures #of List of Fixfures #°f List of Fixtures <br /> Fixiures Fixtures Fiartures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT.�I have reviewed this application and confirm the information contained herein is true and conect. Work done pursuant to this permit must comply with <br /> current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building O�cial before eing authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the woNc for which application is made, <br /> and 1 comply with the te Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett O�cial Use Only <br /> PERMIT# \ ,, � y <br /> <� ���2-��� <br /> OwnerlAuthorized Agent Sig 'Date (Revised 9/23/2016) <br /> �/..� <br /> t <br /> t <br />