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����i-��,���ac��oo� <br /> �3U9L�Ii�G I i�li ECHANICA�./ �L119�i�I�G /SICCf� /�PRD�E����I D��I80L.9�s0�9 <br /> CITY OF EVERETT PERMIT SERVICES <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 /> (�lue or �lack 9�vk Only Ple�se) �R�J��7'SI�'� I���RnliA`r9�F� <br /> PROJECT SITE ADDRESS: 2Z17 'rV� '� U �L L � l; PROPERTY TAX#: v�� �� 'L �`j U�? <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> �Ot��'AC'f BP�1F062MAT90�d <br /> OWNER NAME: �T���r�� ^'y�,�`� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREET ZZp IM ,C ZL ;: <br /> cirr l, �`�[--�=j sTniE � zir� Z('j <br /> OWNER PHONE: p� l —Zq(p3 OWNER EMAIL: \O�ULI(� . `�� � ��Z • (,UY�'1 <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: sTREEr <br /> CITY STATE 7_IP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> BUILDINC PERMIT APPLIGATION <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 ❑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 /> � �;��� -�� �Uz� 11 ������h�� <br /> � <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLI�A'�'ION <br /> Type of Project: New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of Lisf of Fixtures #�f List of Fixtures #�f List of Fi�cfures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixiures <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 Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No. of Heads <br /> ACKNOWLEDGEMENT:1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefiom.Deviations must first be aufhorized in writing irom the <br /> Building Official before being authorized under any ci�cumstance.l am the owner,or I am authorized by the owner of this property to perform ihe work for which application is made, <br /> and I comply with the State ontractors Law 18.27 RCW and 296.20oA WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> ,� , -� i - <br /> Owner/Au orize Agent Signature D te (Revised 9/23/2016) <br />