|
PERMIT APPLICATION
<br /> BUILDING/ MECHANICAL/ PLUMBING /SIGN/ SPRINKLER / DEMOLITION
<br /> '111111.
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 1 FAX 425-257-8857 I(E ,- -------:-.,-*-----4; .; )rw,everettwa.govipermtts
<br /> ,
<br /> (Blue or Black Ink Only Please) PROJECTcet IlltFpIRM' *N
<br /> I
<br /> PROJECT SITE ADDRESS: t FO-7 ii rac,...4 , y• 061— La;OPERTY TA #:
<br /> LEGAL for new construction: Short Plat/subdivision Lot No (attach copy ong legal descriptor')
<br /> CO
<br /> OWNER NAME: LYl 0 L'Avy 1-)Iel-"1, TENANT NAME(If Commercial):
<br /> .,,
<br /> OWNER MAILING ADDRESS: STREET I"a'? 13rd 4... 1.
<br /> 731,,, 'i. <.- td i
<br /> ' 0 G vc,,„,,,,#.4._ gr,,,,,,,,,,,,,. C.4...0,-.
<br /> 25 - 3 7'2 - 5 1 ,....0 OWNEREMAIL:
<br /> „gasta07,7.,,,,.514:-2:10,f-, ',/.."7""(" . NWBATHWORKS, LLC
<br /> CONIWtORABOREW 1882141TH AVE NE
<br /> cay ARLINGTON STATE WA ZIP 98223
<br /> CONTRACTOOPHONt 425-418-9545 ,;,,i(''.•,.l-T-s;;,' ;;::‘,!4:Inilf'., NWBATHWORKS@GMAIL.COM
<br /> '
<br /> CONTRACTOE4ICENSE',Z(';fil(,r:lil417:- NWBATBL855PA CITY OF EVERETT BUSINESS LICENSE a(REOUIRED): 57184
<br /> PRIMARY CONTACT: g OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: t-I 15 - 5 7 '? 5- )0 o
<br /> IS yO u5 L,v--,Th CONTACT EMAIL:
<br /> bial
<br /> BUILDING PERMIT APPLICATiON
<br /> tExteting Use Of Building: Contract Price of Work:$ $1'0000
<br /> cosed Use of Building 1**001W t;19$$$ 0 EleCtrle
<br /> ad I:Aftmad* (,-'_',i7:-1`:-:;-: 131W44114itbittt 1;2------ Pcoiliiii** '00164t4sit
<br /> Type of Project ONew °Addition Ei Remodel DRepair OT.I °Sign °Sprinkler °Demolition °Change of Use .
<br /> DESCRIPTION OF WORK:
<br /> Rert.„0-Ckem 4.„,& $c„,,,,,)
<br /> fASSOCIATED BUILDING PERMIT#(if applicable):
<br /> RM
<br /> P
<br /> AN
<br /> MEC r iiittfititift C- -Tr;---1441444A/itoit
<br /> MECHANICAL PERMIT APPLICATION
<br /> ... ....„
<br /> Type of Project: New Addn Alteration Repair Typry,t,,f4;1,:t1":::::i'i$:$060,-,. Addri Alteration get*
<br /> a of a of fa a #of
<br /> List of Fixtures List of Fixtures *bow List of Fixtures List of Roams_
<br /> Fixtures Fixtures Fixtures
<br /> ,WAfrtliol*ci OW Heat Pump rWt:: Backflow Preventer(Inside Bldg)
<br /> Forced Air Systems Unit Heater Ittntub Urinal
<br /> Gas Pipit. Boiler Lavatory(Wash Basin) Drinking Fountain
<br /> / ta '..'.: ''''fli‘: Refrigeration Shower Floor Drain
<br /> Wood Stove Kitchen Sink&Disposal Grease Trap
<br /> Ducting Dishwasher Roof Drains
<br /> Other ,,' Clothes Washer Medical Gas
<br /> Range'Head ... /' ."!;..,.1,,I*** Other
<br /> ,...
<br /> Exhaust Fan /'N Sink tService/Bar/Mopietc.) Other:
<br /> SPA/ '. '''--4-,-, (--uoimessioN SYSTEM
<br /> c:::i:iK,,,:.:.7.'°:', ,:::7j,,F,, 1 No.of Heads
<br /> -4,,,L*,f,:*4--;, ;IiiiIi.,:':1',,I,V#I:.;'z!r:;''etfOiralliirli", '''.:.Y. ,,l1'./.."k,,,,,,'-'-1,,bili(l. .•,7",104,*.#(4.kr. ,:: :;',''l:,'2: .s,i,'.';'''.*tll'.:'"',,':.4,,,
<br /> -'.,,,,",,,..-',,,l',C,",:,,,..:4,','Itata:
<br /> rn
<br /> :,':--,----,,,It.,:-.:-.::,:befoigiost ,,:,"::: -N-..,'-1,.. ,;;;=,.,.,' , -,:: ., ';',44-7,:-4'',"''':,'1";,,,nififfigrii0iiit'‘'';,;•,',, :''','.,''''.;;;;',';',,l'!,;,**44•,, ,• 1•< .•,,,,;,.'li*,(igiiitio -'77,:)7.,,,I,,.,`1 ',••,•',',,./?:,",•,,
<br /> •,',7-x,t.. ,1,,',,,,,,,, •,,,,•,_ •...if,,,,:,704 -4,'-',Nr,e';',,,'I,'--,'-'"-',':-YAA.:=- ',' ' ' ' - ' - '' " " -'- ' ' -
<br /> -------
<br /> OwnerlAuthp„.51:Atarit Signature Date (Revised 9/23/2018)
<br />
|