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PERMIT APPL.ICATION ; <br /> BUIL.DING /MECHANICAL 1 PLUMBING /SIGN /SPRINKLER I DEMOLtT10N � <br /> CITY OF EVERETT PERMIT SERVIC[S � <br /> 3200 CEDAR STREET,EVERETT,WA 9E1201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everetfwa.gov� wwva.everettwa.gov/permits <br /> - P.IROJFC7'SITE INFORMA7'ION <br /> __ __ _ _ <br /> PROJECT�SITE RE 5• ,.� PRdPERTY TAX#: <br /> � �� <br /> LEGAL for new consfruction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> GONTACT INFOi2MAT10N ; <br /> ,, , _ <br /> , _ _ � ; _;. _ ____ <br /> �WNER NAME: r TENANT NAME Qf Commercial): I <br /> OWNER MAILING ADDRE S; sraeer "cC: 'r�`} i- :.,, I <br /> C�7y STATE � LIP C I <br /> OWNER PHONE: C —� 1— r` �, OWNER EMAIL: �T�_ � � _ �� <br /> CONTRACTORNAME: . . , ,�� v� <br /> I <br /> CONTRACTOR ADDRESS: srReer '��;f� 4� ./ - I <br /> CIlY STATE �(�/ ZIP �� I <br /> CONTRACTOR PHONE: t � _ s`( �•— l ' � CONTRACTOR EMAII.: x �v� ;� . ;,.-�< : �_ ,� I <br /> CONTRACTOR LICENSE#(REQUIRED): , �. , ' '`'�� � CITY OF E ERETT BUSINESS LICENSE#(REQUIRED): � (�l i <br /> _ <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Speciiy) <br /> CONTAGT NAME: CONTACT PHONE: ' � S r-' L �- �;�� ' � <br /> /��`���� �N �. � . �.-P• CONTACTEMAIL: � sC� �� �a , •<<�� i <br /> _ � BUILDING;PERMtTAPPLICATION - ` f <br /> Existing Use of Building: •� - ` Contract Price of Work:$ � ; <br /> � <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Elecfric ❑Other ( <br /> � <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial � <br /> Type of Project: ❑New �Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: � � <br /> ��-;�c��� �it-, ����«.n�.� �� � � ti �� � .�t c'� s <br /> F <br /> i <br /> I <br /> ASSOCIATED BUILDING PERMIT#(if applicable): � <br /> f <br /> ` :MEGHANiCAL'PERMIT APPLICATION" PLUMBING,'PERMIT APPLICATION ; <br /> Type of Project: _New _ Addn _Alteration _Repair 7ype of Project: _New _Addn Alteration _Repair q <br /> #of List of Fixtures ��f List of Fixtures �°f List of Fixfures #°{ List of Fixtures � <br /> Fi�cfures Fixtures Fixfures Fi�ctures ; <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 Heafer Refrigeration Shower Floor Drain �. <br /> Gas Firepla�e Wood Stove Kifchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains � <br /> Clofhes Dryer Hookups Other: Clofhes Washer Medical Gas <br /> Range Hood Water Heater Other: j� <br /> [xhaust Fan Sink(Service/Bar/Mopletc.) Other. <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> --.,. -- - <br /> _ __ -- _ <br /> Number of Heads <br /> ACKNOWLEDGEMEN'�I have reviewed this applrcation and confirm the information contained herein is frue and correr,t.Work done pursuant to this permit must comply wrth I� <br /> current federal,stafe,and local faw.The granting ot a permit onty authorizes approved v✓ork and no deviations therefrom.Deviations must(rst be authorized in w�iting from the ;� <br /> Buildfig Olficial before being authorized under any circumstance.l am the owner,or I am authorized by the owner of this property to perform the work for which application rs made, ` <br /> and l comply with the State Contractors Law 1t3.27 RCW "nd 29G.200A WAC. � <br /> � City of Everett Of/icial Use Only � <br /> � PERMIT <br /> �' ' �� b ` - I�I'1 I�l I Z'� <br /> Owner/ �zed i na ure Date (Revised 10/17l?_095) i; <br /> � <br /> 4; <br /> ,. r <br />