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<br /> BU1L.D�J MEGH,4NICAL.(F'LUNiBtk�G !S1G _' Rt�i6<�.ER 1 DENI�L.I7"IC1N
<br /> C1TY OF EVEREI"T'PERMIT SERV
<br /> 3200 C�DAR STREET,�VERETT,WA 98201
<br /> (P)425-257-$810 4 FAX�}25-257-8857 �(E)everetteps@everetfwa.gov� www.evereftwa.govlpermits
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<br /> FRQJECT SIT�ADDRESS .r.::-� _ _ . iy1� T..7'AX#;�Q � � 'Z O
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<br /> LEGAL fo�new construction: Short PlatJsubdivision Lot No. (attach copy of(ong tegai descriptian)
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<br /> �WN�R NANIE: V'l � T�NANT NAM�((f Cammercial};
<br /> OWN�R MAti,ING ADDRES�: s�aat�' � � 1
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<br /> OWNER PHONE: OWNER EMAiL: O.
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<br /> CONTRACTOR NAME:� /� •
<br /> CONTRAC7QR ADDR�SS: srReer �j�� lklX�
<br /> ClTY STA7E i �P "1�
<br /> CONTRACTOR PHONE: C�N7F2ACTOR EMA(L• .�f �
<br /> CONTRACTQR LIG�NSE#(REQUIRED): �� � CITY�F EYERETT BUSINESS LICENSE#(REQUIRED): L�1J
<br /> PRl�IARY CONTACT: ❑OWNER ❑CONTRACTOR `.�OTHER{Please Specifyj •
<br /> COIVTAGT AME: . COTtTACT PHONE: . .
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<br /> . CONTACT EMA1L: (
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<br /> Existing Use of Buiiding: Contract Price of Wark:$
<br /> Aroposed Use ofi Suilding: Heat Source: as �Electric ClOther
<br /> Building Type: L]SFR-De#acherl �ISFR Af#ached CiDuplex CIMuJfii-Family�#of Units: 1�Pmmereial l�industriai
<br /> TypeofPro�ecf: GNew C�Additipn C1Remodel �1Repair .I. LSig C75prir�kler Clpemo'fi n angeofUse
<br /> DESCRlPTtON OF WORfC: , �, � ���I✓IL �1 , a t2 .P�lls �•C l� /
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<br /> AS50GIATED BUILDiNG PERMIT#(if applicable):
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<br /> Type of Projecf: ,_IVew,� Addn Atteration Repair Type of Project: ,_.,New Addn Alteration _Repair
<br /> #of List of Fixtures #°f � List of�fxtoXes
<br /> #of
<br /> List of Fixtures ��f Lisf of Fixtures ���r� Fixtures
<br /> Fixtures Fixtures
<br /> A/G-Air Handling Units Hea#Pump Toi)et �ackflow Preventer(lnside 81dg)
<br /> Forced Air Sy�tems Unifi Heater � Bath#ub �' Urinal
<br /> Gas Piping Boifer Lavafory(iNash Basin) Drinking Fountain
<br /> Wafer Heater Refrigeratian Shower F�oor Drain.
<br /> Gas Fireplace Woad Stove Kitchen Sink&Disposal Grease Trap
<br /> Gas Range Ducting Dishwasher RoofiDrains
<br /> C(othes Dryer Hookups Other. Clofhes Washer Medicai Gas
<br /> Range Hoad Wafer i-ieater Other:
<br /> Exhaust Fan Sink(ServicelRarlMop/efc.) Qther.
<br /> ���;:SPRINKLER=/:�l;TP.PRESSS�I3�+I��Y'STEIVIr�;`_�:::�-� �
<br /> Number of Neads
<br /> ACKNOYYLEDG�MENT I have reviewed fhis application and confrrm the information confained herein is true and correcf Work done pursuant to this permit musf comply with
<br /> currenf t'ederal,state,and local law.The granting of a perrnif on/y authnrizes approved work and no deviations therefrom.Deviations musf frrst be aufhorized in writing from the
<br /> Building�Offlcial before being authorized under any circurrtstance.1 am fhe owner,or 1 am authorized ky the owner of fhis properfy fo perform fhe work forwhich appCcation is made�
<br /> and! mply with fhe Sfate Conf�actors Law 98.27 RCiN and 296.2ooA WAC. Cify of Everett Official Use Only
<br /> PERMIT# � ^ �/,�
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<br /> Owner! u or�zed Agent Signature ate (Revised 90l1212095) /
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