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• <br /> ,41/P PERMIT APPLICATIA <br /> BUILDING/MECHANICAL/PLUMBING/SIGN I SPRINKLER I DEMOLITION <br /> vi -Alk. _ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits • <br /> (ittije or BIaCk Ink Only Please) : FROgettrit INFORMATION •• • • • - , <br /> PROJECT SITE ADDRESS: far/ 0,14W440P4-3 ii147 PROPERTY TAX#: DDYILI00300700, 00D 3988 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> . - . . . . . <br /> • • - . .CONTACT INFORMATION . .. . . - '.• .. . ' " . ' ' " <br /> . . <br /> • <br /> OWNER NAME: R414qA.15 TENANT NAME(If Commercial): (214.2414, Bprit 6v LAI <br /> OWNER MAILING ADDRESS: STREET iu 14 Euegt..42-avo Lai . <br /> CITY EUeit,,ett- STATE kiA ZIP ciy"Zoy <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: E 0 02.602-66DU 5 TaTti tf-IELT-AI 67-A-c_ <br /> CONTRACTOR ADDRESS: STREET S i SO PA'CA FCC- AU 0- <br /> i <br /> CITY S u e(errr STATE (A/A- ZIP 61 S20/ <br /> CONTRACTOR PHONE: 4'15-2_s-2--3/IL . CONTRACTOR EMAIL: friiiAlat,&q,,S5ivilUA <br /> CONTRACTOR LICENSE#(REQUIRED): E()02.65S 02.2_0 T CITY OF EVERETT BUSINESS LICENSE NREQUIRED): Ca 6-7 al•cs- • <br /> ,..;.,... <br /> PRIMARY CONTACT: 0 OWNER RCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4 2 C-7-52-,il 9 <br /> • <br /> 14404 iØ_ CONTACT EMAIL: A4/4„fac 0 z,e',7fc'eivi 04 1.44,, <br /> . r. . .. .. ... . . . . . . . . . . . . . . . . . <br /> • • • .. BUILDING PERMIT APPLICATION • <br /> Existing Use of Building: /Jo C.,0-1416b1 1 Contract Price of Work:$ /5;Lop <br /> Proposed Use of Building: ti 0 e.,-11-8406t' Heat Source: Iii.Gas 0Electric 00ther <br /> Building Type: OSFR-Detached OSFR-Attached ODuplex OMulti-Family-#of Units: C4Commercial Olndustrial <br /> Type of Project: ONew 0Addition ORemodel ORepair 01.1. OSign CISprinkler CIDemolition DChange of Use <br /> DESCRIPTION OF WORK: Rcv4A.01.4 . , ite.0446 t4 C-011._ /.4.41_6 12_Tc.) - Siv.4.-542,,(bedwiteto zeivieldix <br /> /A) 6 Relat,0 (04.-T-D 0 lol ' <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> ... : .ME-64ANICAL.OERMITAOPLIdATiok • PLUMBING PERMIT APPLICATION • <br /> _ <br /> Type of Project: New Addn Alteration K Repair Type of Project: New Addn Alteration Repair <br /> #of flof #of #of <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> 1 NC—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 /> • , <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 /> • : . <br /> SPRINKLER/SUPPRESSION SYSTEM . . <br /> Number of Heads <br /> 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 <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.I am the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> EksererAuthoriz gent Signature Date (Revised 5/20/2016) <br />