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BUILDING /MECHANICAL/E <br /> PLUMBING I SIGN (SPRINKLER/DEMOLITION <br /> "IIIPH014 CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 1(E)everett$ps@everettwa.gov www.everettwa.govipdm_its <br /> (Blue or Black Ink Only Please) PROJECT SITE-INFORMATION ' <br /> rawn <br /> LEGAL for new construction: ShoPlat/subdivision0 I i <br /> PROJECT SITE ADDRESS:4:62 1 <br /> PROPERTY TAX f#: <br /> .. ..._... ____.... Lot No. attach <br /> --� f copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: / r <br /> TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET S ' A ems..' rr <br /> do <br /> a?v +► r 1 <br /> ir <br /> dP 820 3 <br /> OWNER PHONE: L�2 �*} <br /> Oro •` r <br /> OWNER EMAIL: <br /> CONTRACTOR NAME: ° <br /> tr1 in C <br /> CONTRACTOR ADDRESS: 1"f <br /> srRr_�r ocutuo di <br /> CITY !f • �'1.tt ?� <br /> CONTRACTOR PHONE: STATE A I T ZIP * '" • I <br /> 2.3 a <br /> SO CONTRACTOR EMAiLAw j.^i `t 19 <br /> CONTRACTOR #fREE3UiNE0): .. ,,a�, .V !,� ((I.I .CO <br /> li to 'w`'""' • R CITY-OFEVERETt`BUSINESS LICENSE#tREOUIRED): !DID 9 <br /> PRIMARY CONTACT: 0 OWNER kiCCNTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> D� '_fi_ 50 <br /> CONTACT PHONE: „ ZS 259' O3 <br /> �yY�j CONTACT EMAIL: , ilea <br /> __,„, <br /> BUILDING-PERMIT APPLICATION <br /> ExiMind Use of Buildin.; <br /> Contract Price of Work:S 7 I a, <br /> Proposed Use of Btlildinc: �_.._�._ _ _.. <br /> .---- <br /> Building Type. y�F t Heat Source: JIM. a Electric ❑Other <br /> g yp R-De ache-I OSFR-Attached DDuplex ClMuhi-Family-ft of Units: O strj I._ <br /> Ty e of Project: G7New ❑Addition ❑Remodel [�R;,� ---_-.—...- OCommercial ❑Industrial <br /> DESCRIPTION OF WORK: .gars OT.I. OSign OSprinkier ODemolition ❑Changs.of Use <br /> it) <br /> "kw <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> MECHANICAL PERMIT APPLICATION <br /> Type of Project: New PLUMBING`pERMI7:APPLICATION <br /> Addn `Alteration __Repair <br /> #of Type of Project: New Addn ltera <br /> gtlon iRepatr <br /> Fixtures List et-FlxturBs- __ #°f #of <br /> Mla <br /> ..� x`7-Uw,es _L'stofFixtures– _,Listvf-Fixturs #of <br /> Or <br /> S <br /> F&turvs 'Toilet tf tnr xtures <br /> a�, <br /> Air Handling UrTifs <br /> Hear Pump Fixtures <br /> MaM.la...._EgI_gN_M <br /> IPMguIAmM111N.1 <br /> ced Air Handling <br /> Toilet <br /> Unit Heafer> Urinal ��r Preventer 'Inside Bidg) <br /> Gas Piping Bathtut5 Urinal <br /> boiler Lavatory(Wash basin <br /> Refrigeration ) Floor Dr Fountain <br /> Gas Fireplace Shower Floor Draina1Wood Stove Kitchen Sink&this asai <br /> Ducting Grans Trap <br /> Clothes Dryer Hookups Dishwasher Roof Drains <br /> Canhe Hood Other: Clothes Washer <br /> MI Water Heater Medic Gas <br /> Sink(Se._.. e/BarlAilopietc.) 3TTer7 .— <br /> . <br /> SPRINKLER]SUPPRESSION SYSTEM ` <br /> allinChemical or Water No,of Heads <br /> ACKNOWLEDGEMENT'I have reviewed this application and confirm the information contained herein is true end correct.Work done pursuant to this permit must comply with <br /> current federal,stale,and local law. The granting cf 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 ownor cf ihis properly to perform the work for which application is made, <br /> and!comply with the State Contractors Law 18.27 RCv✓and 296.200A WAC. <br /> • <br /> 4.24 <br /> � ' r /(� Oily of Everett Official Use Only <br /> %...."riz A j tu... –i 2`T•L a PER.Ny1�T iA a 0 O <br /> l �V/ \Y/ <br /> ow,el./Authorized Ag. Signature <br /> Date • f evlsetf 9/23r2D7S) <br />