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PERMIT APPLICAT <br /> BUILD�� MECHANICAL/ PLUMBING /SI PRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SE <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 /> �, w �. « � �,, � � <br /> (�lue r�r B;#ack`�n �,� nly Please)"_ �:� ��P;ROJ�GT �`1'�;INf�R�lild�ON ��� r�- ,��"���;, ��..��.�,�. � <br /> r� , �: <br /> PROJECTSITEADDRESS: 3501 Colby Ave Everett, WA 98201 PROPERTYTAX#: 01063800010100 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> �j # � � ��;�GO'NT��T INF�.1,R1�11�'�' 1QN � ' � ; �,� �,� K� ��� �fN . ���� r ; <br /> � � � <br /> �. .�. ;� ��..�: e.�,..�..,�,����.�: <br /> OWNER NAME: James Company TENANT NAME(If Commercial): Lifelong <br /> OWNERMAILINGADDRESS: s-rReeT 154 Village Court Suite 100 <br /> ciTv Monroe 87p7E WA ZiP 98201 <br /> owNER PHONe: (4 2 5) 2 6 9-3 3 31 OWNER EMAIL: <br /> CONTRACTORNAME: Pacific Air Control <br /> CONTRACTOR ADDRESS: s�aeeT 1916 2 2 0 t h St St e . Ml 01 <br /> cin Bothell STATE �1A ZiP 98021 <br /> CONTRACTORPHONE: �888) �22-4822 CONTRACTOREMAIL: LEOT@PACIFICAIRCONTROL .COM <br /> CONTRACTOR LICENSE#(REQUIRED): PAC I FAC 2 3 O P 8 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 113 4 7 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2 O 6—512—9 8 O 7 <br /> Leo Tereshchuk CONTACTEMAIL: leot@pacificaircontrol . com <br /> ": ' ``��.�4 ���� �.� �n�� ` < � �D1�NG;� IT�k i�.� " `T11ON������� . �;,������ �,������;" ,,�,�i� ���,�t <br /> � -;�� ,4. ,� ��� 1� R.� ..1"`�+�. ���$�� _.�. ,�rv �>aT ���:..�,.. <br /> Existing Use of Building: Contract Price of Work:$ � �� <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> T pe of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: /�� <br /> ������� �Lh s�t 1�'� �.�J o"�-�^' 1d�l--lo' �o >C� �oZ 7,� i-�.�.,o.� <br /> ��,� �����%� `r 1� , ��I nG�,� ll ,s �,.`d;d+�s�'s�Cx`�� � <br /> s� �.� / ��- 5� j ��� �v,�o� J �` ���. <br /> �� � � <br /> ASSO�IA ED BUILDING PERMIT# if a licable: <br /> � t�_ s � x s A: <br /> MECHANICAL_PERMIT APPLICATION=^ ., i n� PLUMBING �ERMIT�I�PLICA'�Iy�l� _ ;�. �,;�t�., .; <br /> Type of Project: _New _ Addn X Alteration _Repair Type of Project: _New _Addn Alteration _Repair <br /> #of ��st of Fixfures #of List of Fixtures #of List of Fixtures #�f List of Fi�rtures <br /> Fixtures Fixfures Fixtures 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 1 Other: VAV Clothes Washer Medical Gas <br /> Range Hood 2 7 D i f G r 1 Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> 3PRINKLERr'/SUPPRESSION SYSTEM' . <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT:1 have reviewed fhis application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comp/y with <br /> current federal,state,and local law.The granting of a permit on/y authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building O�cia/before being authorized under any circumstance.1 am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett O�cia/Use On/y <br /> fi' r / / �� PERMIT# +6 <br /> (/ ° 1/2 3/18 �� �0 [ �� a�..F--� <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) s` <br /> ��: 1 ,�, '`� <br /> �. <br />