716 SE EVERETT MALL WAY MODERN HOME FURNITURE 2018-05-16

PERIlIiIT'APPLICATIO� BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits (Blue or Black Ink Anly Please) PROJECT SITE INFOR TIOW PROJECT SITE ADDRESS:� l � S �-C— PROPERTY TAX#: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: � ,;� , p�.�1�� , �,��; TENANT NAME(If Commercial):�`c1�'" �1 1,,Cy�--�� h,l� � ,-� '� OWNER MAILING ADDRESS: sTREET �O , \ 1 �� Z� � �S�`�lC_�C_ �r�Z-- CITY ��t�.i.� �O� �_.�:� .� STATE ZIP �� -C C�� OWNER PHONE: z�`j ? ^ �� `� �--� ZZ�Z'� OWNER EMAIL: CONTRACTOR NAME; �►�� I`��4��c�\C !�` ��2 S ` �� ` �Z�� CONTRACTOR ADDRESS: srREEr Z-�l Z- �.,�C✓v-�� L,•` � . � ��Z�� CITY STATE ZIP CONTRACTOR PHONE: \27 r ZS c7 � �� CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED � CITY OF EVERETT BUSINESS LICEN #(REQUIR D): C �� -7 E� PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ,1�OTHER(Please Specify) ��S?�3,�.L�� `��. C�z CONTACT NAME: CONTACT PHONE: i�Z� - �c � � �'��y O __�, CONTACT EMAIL: —y� BUILDING PERMIT APPLICATION Existing Use of Building: � ��--:L- Contract Price of Work: o� ��S� ^ Proposed Use of Building: Heat Source: ❑Gas ❑Electric Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. �'ign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteretion _Repair Type of Project: _New _Addn _Alteration _Repair #of Lisf of Fixtures #�f List of Fixfures #°f List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal ;' Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer � Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPIZI�IfCI.EIt/ SllPPE3E��l��!! �X'�'I'EIVI Chemical or Water No. of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,sfat ,and local law. The g�anting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from fhe Building O 'ial befor being authorized underatt ircumstance.!am fhe owner,or I am authorized by the owner of this property to perform the wo�k for whrch application is made, and I co pty with the State 6ontractors Law 18.27 CW and 296.200A WAC. City of Everett O(frcial Use Only �_ ._��c� ``- f C/ � � j P E T# � ,�, OlJ q _-�' � ner/Authorized Agent Signature Date (Revise /2 /2016) � 0� — � ��.