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I , <br /> IIII''II <br /> PERMIT APPLICA--I <br /> BUILA6 / MECHANICAL/ PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> siii01.40/:"6,- <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> :(Blue or Black Ink Onl .Please PROJECT S,IyTE I JFOuRMAT1ON , <br /> PROJECT SITE ADDRESS: 1 3)7 11 e uta I TT AA" EF N 40 e- PROPERTY TAX#: ati 43916 7 0 D14-00 <br /> LEGAL for new construction: Short Plat/subdivision Eru• Pill-j' f t.(.t 6 7. Lot No.(.'1'-I ei(attach copy of long legal description) <br /> „. CONTA01NFORMATION 3, 7 <br /> OWNER NAME: C. E p os — I.1 OLT (.i.e, /H O S w TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET Z u 2 g a L.c /LEtz- /E-v2 W(JC G <br /> CITY ever'E7T STATE (,V ti- ZIP ` IS z O I <br /> OWNER PHONE: .--. OWNER EMAIL: — <br /> CONTRACTOR NAME: L 117 eco_r'/ Cit-l.-3 1 /.3C,• <br /> CONTRACTOR ADDRESS: STREET / l"7 $-2:7 c o rst /4....s' NCS 41-2. .Z.,4- <br /> . <br /> , -. Q <br /> CITY K.G J `''I0 12-4? STATE Lt.,4.- ZIP c,S 0 Z,$ <br /> CONTRACTOR PHONE: C j-7 ) 4 S 7 • (. 4 312 CONTRACTOR EMAIL: +17e.rt o If 6 l r 119 Gro- C, Ceo <br /> CONTRACTOR LICENSE#(REQUIRED) L I T3 6R C 1 t IL C() CITY OF EVERETT BUSINESS LICENSE#(REQUIR ) Eit21 id <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR OTHER(Please Specify) A'(-c-1ft t CT <br /> CONTACT NAME: Z„3 i'Z /4 CLCK sTit'+C-[4,/2 is CONTACT PHONE: C4-3-5 ) -2.. . Z. • Z 153 <br /> 11 G S r .3-k tut a S o+-J CONTACT EMAIL: (-tics & Z';1 L 4,04 f CC ft .C Its", <br /> i <br /> BUILDING PERMI,TAPPLICATIONG <br /> Existing Use of Building: g Contract Price of Work: 3 Z. O <br /> Proposed Use of Building: f3 Heat Source: ❑Gas ❑Electric i• er <br /> Building Type: ❑SFR-Detached ❑SFR-Attached 0 Duplex ❑Multi-Family-#of Units: Gommercial 0 Industrial <br /> Type of Project: El New ❑Addition 0 Remodel 0 Repair T.I. ❑Sign ❑Sprinkler 0 Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: -t`,,.7.4 4.espy I Ai f R 0&, -1 Ell/T <br /> LA' fr..'" aL o J ? 5S S, r- F.a- <br /> 41 & L3 t --ZJ TY 9 o' T r &I-we- <br /> ASSOCIATED <br /> i✓e- <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION ' PLUMBING PE"RMITAPPLICATION11 ' <br /> Type of Project: _New Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pu Toilet Ba ow Preventer(Inside Bldg) <br /> Forced Air System Unit eater Bathtub urinal <br /> Gas Piping iter Lavatory(Wash Basi`, _ 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 Hook Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER;/ SUPPRESSION SYSTEM <br /> Chemical or Water I No. 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.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> �� P S#dol _ 0 <br /> 32_ (( ) <br />