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P <br /> RMIT <br /> BUILDIa I MECHANICALS/PLUMBING ICS GNB/SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> #� 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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3 c U I 6Yjoa JWfi/1t/ PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION ‘..j i FF LOC; <br /> OWNER NAME: a52.-: C/},,,jp,a V i iv TENANT NAME(If Commercial): <br /> ✓ <br /> OWNER MAILING ADDRESS: kg* /J ,1'f S/' <br /> CITYaC(&//Gly STATE/ /69 <br /> 6/ ZIP old 3a <br /> OWNER PHONE: '31(e-7.R(r 'jCp OWNER EMAIL: L._///k/ 4L)e olfz-Ac/////ez,„&Del <br /> CONTRACTOR NAME: W G 0-o", ± j j/ }�A <br /> CONTRACTOR ADDRESS: STREET //B62/4/ <br /> 0� 00// W od�Vt`k �J'C.. <br /> CITY /✓6//4,/ STATE /fr/ ZIP 'AO.. <br /> CONTRACTOR PHONE: `f9S _'7 6.- (€V-3 CONTRACTOR EMAIL: . of gt„te_j 01,r ,c <br /> CONTRACTOR LICENSE#(REQUIRED): W 6.1,Jv Li 141)19 5 C.3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):i/. c//3 <br /> PRIMARY CONTACT: 0 OWNER i6 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: C orC-cJ r 73'c <br /> 67/JQ S CONTACT EMAIL: ( s(4,f/e iteil)-11 <br /> BUILDING PERMIT APPLICATION cx esgatiF <br /> Existing Use of Building: Contract Price of Wo $ 9U/Opp z.L___ <br /> Proposed Use of Building: b'aplie. Heat Source: `,,0'Ga• ❑Electric ❑Ot r-r, <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units C,]eo • ercial 0 Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel DRepair OT.I. ❑Sign ❑Sprinkl ❑Dem..".n ❑Change of Use <br /> DESCRIPTION OF WORK: /2,eidace ( '/Ze/O/1 //j,/?/�,j-•75-,. .4,4„6„,. . „y% /,1�d2 6c� r <br /> '41,1.7 'AV-AA/4d civ 4,0 we/0V I l N/ 'l io e,,,v <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_ Addn _Alteration .air Type of Project: _New _Addn _Alteration "epair <br /> #of List of Fixtures #of L.t of Fixtures #of List of Fixtures #of 1st of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC-Air Handling Units Feat Pump Toilet flow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower - Floor Drain <br /> Gas FireplaceWood Stove Kitchen Sink&Dispose Grease Trap <br /> Gas Range Ducting Dishwasher z Roof Drains <br /> Clothes Dryer Hoo ,:.s Other: Clothes Washer Medical Gas <br /> Range Hood Water Heate Other: <br /> Exhaust Fan Sink(Se e/Bar/Mop/etc.) Other: <br /> SPRINK ; R I SUPPRESSION SYSTEM <br /> Che ' al or Water I No.of Heads ”- 2 . -"A <br /> ACKNOWLED a MENT:l have reviewed this application and confirm the informatio ontained herein is true and correct. Work done pursuant to this,-rmit must comply with <br /> current federal,state,and local law. The granting of a permit only authorizes appr•,ed work and no deviations therefrom.Deviations must first be authorize. . '••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 /> �� - ��a /�" P Czke--.0 - c��- <br /> M! , <br /> Owner/Ruth. ed A `•- re Date (Revised 9/23/2016) <br /> 1 <br />