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• <br /> 0;077, PERMIT APPLICATION <br /> BUILDING 1 MECHANICAL/PLUMBING/SIGN I SPRINKLER/DEMOLITION • <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I wtwreverettwa.gov/permits <br /> (D►ue.or Dlaele lfiik kinkPlease) . : . PR•JEC I'SilTe INFOWIA`)[ION ' <br /> PROJECT SITE ADDRESS: 315 £, ioc. AD S.0-6 Et JPROPERTY TAX#: Z8 7.5 7 003 c::•/ S o <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> .• Coia1TACT ILII ORMAu1®N <br /> OWNER NAME: 'SAw y'O 'TlW 7 TENANT NAME(If Commercial): 14L <br /> OWNER MAILING ADDRESS: STREET 'j/OD 6;11 -7161f w1 $fl '14 f • <br /> cITY Sucece STATE w6i, ZIP 91203 <br /> OWNER PHONE: 425- 7(1t0- 22�r`l OWNER EMAIL: ; /exj0)6-Qwei mu.) ,,Nh,,, <br /> CONTRACTOR NAME: .EUICYC.CaU=+ AJ.._,...6'`roc-7r ...•�tqE I�67A-c,.................. .r....,.......,._.,..,.,.... ... M <br /> CONTRACTOR ADDRESS: STREET '2-1 PAC.-1 Ft-C_ A()g" p� <br /> COY Ftd UC STATE W> .A,- ZIP I SO0/ <br /> CONTRACTOR PHONE: 4'25 2-S 2.. 3 f/Li • 'CONTRACTOR EMAIL: miew_ es s950fl&s4 ,Ca,-. <br /> CONTRACTOR LICENSE#(REQUIRED): EUG-12.65S®atr?1' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): f.2 tj--/ei 5-5" • <br /> PRIMARY CONTACT: 0 OWNER aCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4 7 5.---2-5-2. ,i/9 <br /> IV P4V- CONTACT EMAIL: e, <br /> • ' . ' BUILDING PERMIT APPLICATION ' . - . •. . • , • <br /> Existing Use of Building: t.`�® Che 1 Contract Price of Work:$ eZ.J e c <br /> Proposed Use of Building: Gv U CtE & Heat Source: ❑Gas i Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR Attached ❑Duplex ❑Multi-Family-#of Units: I�Commercial ❑industrial <br /> Type of Project: ❑New ❑Addition I:Remodel IIRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Rot,t- <br /> W iltl 110 e H bO6as IV ©u‘47,430‘16- <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> ECANICALPEIAPPLICATI®� <br /> . .M , 1 . . . PLUMBING PEDIYIIT APPLICATION • <br /> Type of Project: New Addn Alteration Repair Type of Project: _New Addn Alteration _Repair <br /> #°f List of Fixtures #°{ List of Fixtures #°f List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures 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 Lavatory(Wash Basin) 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 Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> intiki KLEG 1�U --=SSION SYSTEM ' ' ' <br /> S <br /> 1Num ber 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.lam the owner,ori 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 18.27RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PEw ; Ct <br /> O 11Authorize ent Signature ( R A.c Date (Revised 5/20/2016) `/ <br /> h / i <br />