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PERMIT APPLICATI41-
<br /> ?11,%11!".----.A- BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER I DEMOLITION
<br /> t'IVI CITY OF EVERETT PERMIT SERVICES
<br /> ' l 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 i FAX 425-257-8857 i(E)everetteps@everettwa.gov I www.everettwa.gov/permits
<br /> r k Ink Only ii eL� _r - +� INFr>nimATI Vit_ . ?„
<br /> PROJECT SITE ADDRESS: 4 -f t? 4 , A t'W W't 17 PROPERTY TAX*: 0043916700140 ,
<br /> LEGAL for new construction: Short Plat/subdivision -ryyr�33 Lot No. y■y (attach copy of long legal description)
<br /> �yy/{i ;yv
<br /> OWNER NAME: CEP 06—Hart. LLC, and HOSCO, (I C TENANT NAME(If Commercial): Waxology@Beauty Boutique
<br /> OWNER MAILING ADDRESS: STREET 2829 Rucker Ave, #100
<br /> cm Fvprptt STATE WA ZIP 98201
<br /> OWNER PHONE: 425-339-3638 OWNER EMAIL:
<br /> bcarltonpcoastmgt.com
<br /> CONTRACTOR NAME: Backflow Testing & Service, Inc.
<br /> CONTRACTOR ADDRESS: STREET PO Box 42
<br /> my Lake Stevens STATE WA zip 98258
<br /> CONTRACTOR PHONE: 425-334-3350 CONTRACTOR EMAIL: backflowtestingandsefvice©yahoo_corrt
<br /> CONTRACTOR LICENSE#(REQUIRED) BACKFTS893MR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) n5 7.4,5, ..
<br /> .,, t ,.,,. . , ,TM_,,P., r n. , „, _ .amu �, M ,,7 „w .,, .,,,,,-,t,,,,,, ..,� �.., , .. , ,. ..�.,,,, . . ..,�.�n ,,, v ,...,_,, g M.n...
<br /> PRIMARY CONTACT: 0 OWNER ,bONTRACCTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 206-255-9646
<br /> Thom Wahiman CONTACT EMAIL:
<br /> same as contractor
<br /> Existing Use of Building: Contract Price of Work:$,
<br /> Proposed Use of Building: ,Heat Source: Deas °Electric °Other
<br /> Building Type: °SFR-Detached °SFR-Attached °Duplex °Mufti-Family-#of Units: OCommercial °industrial
<br /> Type of Project: °New °Addition °Remodel °Repair DT.I. OSign °Sprinkler °Demolition °Change of Use
<br /> DESCRIPTION OF WORK: n\uffi / -r\ SAA,91A-Y
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> GHA$lii Pl ill} •APP14ii> Al ilii=: PIll> 41:0::1$0041' . 'P 0A11,0N
<br /> Type of Project: New Addn Alteration Repair Type of Project: New _Addn , ►Iteration Repair
<br /> Flxetu�res List of Fixtures Flxtu List of Fixtures Fixtures List of Fixtures FIS List of Fixtures
<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 2 Lavatory(Wash Basin) Drinking Fountain
<br /> Water Heater Refrigeration Shower Floor Drain
<br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap
<br /> Gas Rare Ducting Dishwasher Roof Drains
<br /> Clothes Dryer Hookups Other: 1 Clothes Washer Medical Gas
<br /> Range Hood 1 Water Heater Other:
<br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other.
<br /> Chemical or Water t fNo,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 I., '- ore being authorized under any circumstance.I am the owner,or!am authorized by the owner of this property to perform the work for which application is made,
<br /> and I c. the State Contractors Law 18.27 RCW and 298.200A WAC.
<br /> City of Everett Official Use Only
<br /> GIL 1 ,Yai / PERMIT* PrTh2— o --
<br /> OwnerlAutho
<br /> Agent Signature Date (Revised 9/23/2016)
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