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Feb 21 2018 12:44PM Washington Wate aters 8663757454 page <br /> PERMIT APPLICA710N <br /> BUILDING ! MECHANICAL! PLUMBING / SIGN !SPRINKLER/ DEMOLITION <br /> GITY OF tVERETT PERMCf S�RV'CGS <br /> 320Q CEDAR STREET,E`JERETT,V'JA 98201 <br /> (P)425-257-B81 Q � FAX A25-257�857 �(E}everettepsQeverettwa.gov� wwvv,everottwa.gov/permits <br /> (Blue or Black Ink anly Please) PRQJECT SITE iN��RMATION <br /> PROJECT SfTE AObRESS: ��� �� �{, �j� PROPERTY 7AX#: <br /> LEGAL for new construc:ion: Short PlaVsubdivision Lof Na. (atta�h copy of long legal description} <br /> CONTACT ttd�ORMAT[ON <br /> OWNER NAME: ` ��' ��j TENANT NAME(lf Commercial): <br /> OWNER MAILING ADDRESS: srRF� �U?J�. 2"� P t <br /> cirr sra�e V� bP � 0 fi(1 <br /> OWNER PNONE: Gj✓ ��' q � (} OWNER EMAIL: --- ' <br /> CONTRACTOR NAME: ��5}�(IU�Jj"�N ��f 2 }—��T��C.S <br /> CQNTRAGTOR ADDRE55: srReer ��(�Z. �[�y� �-{/'� � — G U�C 9�J <br /> / z�v <br /> CITY �1,��� STATE uI� <br /> CONTRACTOR PHONE: �Z J�� — CaNTRACTdR EMAIL: '` �/��[,, ���'j? <br /> GONTRACTOR LICENSE#(RE�UIRE�): ��-��"y��� C1TY OF EVERETT BUSINESS LICENSE#(REQU1REQj: ,� <br /> PRIIVIARY CONTAC7: O OWiVER CONTRACTOR �07HER(Please Specify} <br /> CON ACT NAME� CONTACT PHONE: ��.�' 3 —L{g'7/ <br /> `-"+�-� �L��+!�I� CON7ACT EMAIL: W{�f�U�.fll�/�.��/jrcn!rL. �/yy, <br /> � � <br /> UILD[NG PERMIT APPLICAT[ON <br /> Existing Use of Buifding: Contrect Price of Work:$ <br /> Proposed Use ef 8 'dinc; Neat Source: ❑Electric ❑Other <br /> Buildin Type: R-Detached �SFR-Attached ❑Quplex ❑Muiti-Family-#ofUnits: ❑Commercial ❑fndustrial <br /> Type of Pro;eci: ❑New DAddition ❑Remodel �Repair ❑T I. C�Sign �S �inkler ❑Demolition OChan e of Use <br /> DESCRIPTIO�{OF WORK: <br /> �:�w�� o►..,�,r�. l o�w wC�.�-c,v <br /> A550CIATED BUILDING P�RMIT�(if applicable : <br /> MECHANICAL PERMIT APPLlCATION PLUMBING AERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration Repair Type o(Project; New Addn Alteration �Repair <br /> #of ^ ` " � —J <br /> Fixtures List of Fixtures #�f Lisi af Fixtures #of Lrst of Fixtures #oi Llst ot Fixtums <br /> Frxiures Fixtu�es Fixtures <br /> A/C—Air Handling Un�ts Heat P�mp Toilet Backflow Prevenier(Inside Bldg) <br /> �arced Air 5ystems Unit Heaier BatMub Urinal <br /> Gas Piping Boiler Lavaiory(Wash 6asin Drinkin Fountain <br /> 'Nater Heater Refr� ration Shower Floor Drain <br /> Gas Firepface Wood S!ove Kitchen Sink&Disposal Grease'rrap <br /> G8S Range Ducting Dishwasher f2o0f DC2ins <br /> Ciothes Dryer Hoakups Other: Clothes Washer Medical Gas <br /> Range Hood Wacer Heater Other: <br /> Exhaust Fan 5fnk(ServicelBarlMo letc. Other: <br /> SPRINI(LER/SUPPRESSION S1fSTEM <br /> Number of Heads <br /> AGKNOVJ4E.7GEMENI)I l�ave reviewed ll�is applicalion and confirm fhe inlo�matiat contahiedlrerein is frue and correc�. Work done pursuant to(his permit must compfy with <br /> cu�renl ledoral,stafe,ortd;oco!law. The 8ranting ol a permit only aurnor�res approved work arld no devialions therefrom.Deviations must firs!be aufhorized in wrifing hom 1he <br /> Burfrling OfliGa!OQfcre laoing autho�ized under erty ci�canu!ance.1 am fl�e owner,o��dm dufhorized by the owner oi lhis prnperty ta peri«m Ihe work(ar whicii sppYcatlon Is made, <br /> enC r compry�viip ll�e S1o10 Gontraefors Lnw P�,27 RCW an 29B.2ooA W�1G. <br /> c City W Everelt O�cia1 Use Ort1y <br /> `Z,2fj( U PERfVI�# _ <br /> �� ��2� �����> <br /> O erlAutftorized Ac�ent Siynalure uale (Revised 517p/7.016; <br />