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f �_ �N BUILDING I MECHANICAL/PLUMBING I SIGN/SPRINKLER 1®ENl©LITION <br /> CITY OF EVERE I I PERMIT SER_ <br /> ` = 3200 CEDAR STREET,EVERE I I,L. mYl <br /> (P)425-257-8810 I FAX 425-257-8557 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> .ictj _ezv - p,.:� ••:s_ - ] 9{ iKO7.Sr # 113 <br /> 1Q0'0iQl_�_.,.f' t,. .. <br /> PROJECT SITE ADDRESS: su <br /> i is r . PROPERTY TAX#; <br /> LEGAL for new construction: Short Plat/subdivision °..e.-v- A/e. Lot No. (attach copy of long legal description) , <br /> .._e. _r... '••12aFi:A;ty_e.. at ::r<:•l:is i' 1rt< _il w• y. - - :.l r.i. <br /> OWNER NAME: E V t,e-E 1T f US i iJ c ,I4 iti.... TENANT NAME(If Commercial): 144 eeM_o VJS of.......,pr <br /> OWNER MAILING ADDRESS: smEEr ?.d + g-0 X.. I SY <br /> CITY E'V''—4'4—{` ,STATE W`4- zm 8204-16-9 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: PiU-I E® Cerysa S' lO'.- r <br /> CONTRACTOR ADDRESS: STREET 11-€A..) ° -Hr five �1�? Cocm, C�'✓-c-� STATE L-) zip C V 7.._0 <br /> CONTRACTOR PHONE: CONNNTRACTOR EMAIL: toil,LICENSE#(REQUIRED)•XU, JjIk 111 5 tp1 CITY OF EVEREfT BUSINESS LICENSE#(REQUIRED): 031 U/ <br /> PRIMARY CONTACT: D OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: . CONTACT PHONE: LI-7_5Z j ^ L(0 1 4' <br /> et-r1/4...` Vin f�1 t-) `C-t-st... CONTACT EMAIL: (trip,iq vel e_V k4 • ®'f`q.( <br /> - - - - - =- ,`�°�°'��==--=BUILD*�I'�:PER.1Mtal Wiz.__:tL-•--•-- -_�_. ..t._. . - <br /> _..... rye• -+_ xa. -.z= �-z•F-::t'--_�^.:,...^.sY�.-:"� <br /> Existing Use of Building:r re f cs /' f ° �� +3-Contract Price of Work:$ l ©`.f • <br /> Proposed Use of Building: Heat Source: DGas DElectric DOther <br /> Building Type: DSFR-Detached DDSFR-Attached DDuplex CDMulti-Family-#of Units: C(Commercial Dlndustrial <br /> Type of Project DNew DAddition DRemodel JJRepair DT.I. DEign DSprinkier DDemolition DChange of Use <br /> DESCRIPTION OF WORK: , / ;� ..C.' et y°�'S <br /> eF'C e-r CEO i S I .,,.1� L t f J ° t. t,,O�rq Yn�E7r1 <br /> tr�N i L rviEi n"C... STf-'rr.4 ) e`►5 A e..e cif.e ca <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> P]:titfIr7 .PNl+IVAP ;ICA'1'1t3'N <br /> Type of Project: New Actin Alteration Repair Type of Project New Addn _Alteration Repair <br /> #of #of #of List of Fixtures #of List of Fixtures <br /> Fixtures List of Fixtures List of FixturesFixtures <br /> Fixtures Fixtures <br /> • <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 /> 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.lam the owner,or I am authorized by the owner of this properly to perforin the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only <br /> 6 �� PERMIT# t C (00(0 — D?2' <br /> 2015 -` <br /> Owner/AuthonzedAgent ignature Dat (Revised 10/12/2015 <br />