15 SW EVERETT MALL WAY BASE FILE 2018-05-16

I� ��ir A��Lic�-rior� �UILDING/ MECHANICAL/ PLUMBING I SFGN 1 SPRINKLER I 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 Only Please) PROJECT SITE 1 R T101� PROJECT SITE ADDRESS: �� 5.F.�. �/,g/-G Lt/cL PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INF ATION OWNER NAME: G^— �r 1 G TENANT NAME(If Commercial): � � ��5 �s� , OWNER MAILWG ADDRESS: sTReer � aa 3 crrv ev � sTA� ziP p!� OVVNER PHONE: OWNER EMAIL: CONTRACTOR NAME:�� 'n �1 L CONTRACTOR ADDRESS: sTReer ��y z �� /G CITY �Q,/' S v ��j � STATE ZIP z ? CONTRACTOR PHONE:��j D � ' Q CONTRACTOR EMAIL: ,� G�' CONTRACTOR LICENSE#(REQUIRED): e� � CITY OF EVERETT BUSINESS LICENSE#(REQUI D): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) cr,�N '� e�- CO A NAME: CONTACT PHONE: ��d �j 3 � �y6 �� CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: '�9£ommercial ❑Industrial Type of Project: ❑New �Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: �nS �ti�` ��f�t*'�l h�H.�} D� � �v �.�yp� � �O�/ �'i _.3 ASSOCIATED BUILDING PERMIT#(if a plicable): ��7 d 6' �� z MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLIC/�TION Type of Project: _New Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair #of Lisf of Fixtures #of List of Fi�ctures #�f List of Fixtures #°f List of Fixtures Fixtures Fixfures Fixtures Fixtures A/C—Air Handling Units Heat Pump � Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinai Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Firepiace Wood Stove Kitchen Sink&Disposai 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: SPRINKLER 7 SUPPRESSIAN SYSTEM Chemical or Water No.of Heads ACKfVOWLEDGEMENT.�1 have reviewed this application and confirm the information contained herein is true and correct Work done pursuant to this permit must comply wifh current federal,sfate,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviafions must�rst be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to pertorm the work for which application is made, and I co y with the Sta Contra ors Law 98.27 RCW and 296.200A WAC. City of Everett Official Use Only —Z�—�o T� rOC��" Owner/ horized ent ignature Date (Revi d 9/23/2016)