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03/26/2018 MON 9: 08 FAX 425 415 6867 Fast Water seater I0004/004 <br /> • <br /> PERMIT APPLICATION"#7'r''4 -"g,mdaY.,-, <br /> BUILDING/MECHANICAL/PLUMBING/SiGN/SPRINKLER/DEMOLITION <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> . (P)425-257-8810 J FAX 425-257-8857 I(E)everattepe reverettwa.gov J www.everetlwa.gov/permits • <br /> i .ibe or 11311ack Ink Only Plensea PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: a(1-1 j l p 2 0,-;5 Di-I in y <br /> LEGAL For new construction: Short Plat/eubdivision Lot No. (attach copy of long Legal description) <br /> CONTACT INFORMVIATION <br /> � N --r—' <br /> OWNER NAME: l� � TENANT NAME(ft.commarclat): <br /> OWNER MAILING ADDRESS: STREET t t D`�Q/_ G � . _ ___-.. ___. _ <br /> cny p�/Y e STATE`4,4zip. 61 (.7 06(- <br /> OWNER PHONE: tins 5p"{ 153'3 J <br /> OWNER EMAIL: , <br /> CONTRACTOR NAME fPc SI- Vl Ai i� titSAT Z,'K. . <br /> CONTRACTOR ADDRESS: sn er , ► 15 N rt. p k4 s X' C I` � .r{7 <br /> CrIY _t V \ ` �IV _ STAIN 1pl"/��+ ` 7Fc <br /> CONTRACTOR PHONE: (425- jo CONTRACTOR EMAiL:p?k 0-5 pv-tpirwavAr Aga r, (,c ii <br /> CONTRACTOR LICENSE#(REQUIRED):f�Silk kU Vi9�R 1j� (CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)SIJ 3 <br /> PRIMARY CONTACT: LI OWNER p6ONTRACTOR D OTHER(Please Specify) . -• <br /> CONTACT NAME: /� � CONTACT PHONE: y p-5-- �3 <br /> K4 �l"1 ' CONTACT EMAIL: <br /> -ice �, + <br /> - 5-1'vJa (IA P1MWil <br /> BUILiDING PERMIT APPLICATION <br /> E detint Use of Bulldin•: S 1i' Contract Price of Work:$ «� <br /> - <br /> Proposed Us®of Building: s / M®at Source: Cas ©Glectrfc �70ti1er <br /> Buliding Type:)4SFR Detached L SFR Attaohecl CIDuplex IJMulti-FamlIy#of Units: .OCammerclal Dlnduetrial <br /> T •e of Pro'ect: ONew DAddition JRemodeel ,i Re.air MT.!. CDSI•n Lis•rinklar ODamolttion ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> f' 6111) D\IC / 1(ekiP\ -Ce C)A S Lk)00-eAr \fl e ate-/r. <br /> ASSOCIATED-BUILDiNG PERMIT#(If applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION r._..___ <br /> Type of Project; New Adcn _Alteration _Repair Type of Project: ,__Lew „__Addn ,_,,Alteration _Repair <br /> #of LW of Fixtures #of List of Fxfares #of List of Fixtures -#of List of Fixtur'ees <br /> FixturesFixtures Fixtures Fixtures„� <br /> A!C•-Air Handling Units Heat Pump Toilet Backflow•ii.vantsr(inside Btdg) <br /> Forced Air Systeme Unit Heater Bathtub Urinal <br /> Gas PI in Boiler Lavatory(Wash B Drink! Fountain <br /> Water Heater "Refrigeration . Shower Flo rain <br /> Gas Fireplace Wood Stove Kitchen Sink& Is Deal ease Tra• <br /> Gas Ramie Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups '�"'-Other: Clothes Washer Medical Gas <br /> Ranke Hoed - <br /> Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/ ,, Illei„„„_ Other: <br /> SPRIN, ---..a.idci --- BSSIO . • , _M • ..�.._ <br /> c entice!ar W- = •• R •..of Heads <br /> AOKNOWI_EDC3EMJ;N7:•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 /> curreeni federal,;fete,and local law,The granting of a permit only authorizes approved worn and no deviations therefrom.Deviations must Mat be authorized in writing from the <br /> Building Official Belch,being authorized under any circumstance,I em the owner.ori em authorized by the owner of this properly to pefbrm the work for which eppiloatlon La made, <br /> and I comply with the State Contractors Law 16.27 ROW and 296,200A WAC. <br /> City or verett Mole/Use Only <br /> 3 - - i PEPIV1T# `o <br /> Own uthar ze Ag SignaWre Date <br /> (Revised 9V23/2046) <br />