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II II ''II PERMIT APPLICATIONth <br /> BUILDINU 41ECHANICAL/ PLUMBING/SIGN ftPAINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE.INFORMATION <br /> PROE lSIT D S2� 1I6c.Q39-6N 1104 P3PE0RO6 <br /> �-� k - 2000\ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ,t1kCii U <br /> CONTACT INFORMATIOt!1(.;j , • <br /> OWNER NAME: DOUG NGlet,-- TENANT NAMEE®(If Commercial): 6? tM_ I tor&R A5r- <br /> O• � g MAILING ADDRESS: STREET 6,,4^^-t 0 5V 5I FJ2 K) to/' g_ B AO1O CDOW �j <br /> NAN • CITY W E- LL I,, �,,�STA,TEI,�IVB/ ZIP �EL.,®� <br /> OWNER PHONE: l-25 ,��' 5J ® 2381 OWNER EMAIL &ASo 06At,97 alt\fvt al Covvt <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: (CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR WOTHER(Please Specify) , ttI TQC_ <br /> CONTACT NAME: e1sk .t t� �(,(_E HULLE CONTACT PHONE: 206 7g a— Let <br /> C.1"C.1" DEpe®$O Alar.t$tT c-1- CONTACT EMAIL: o C. 'O clog-ay-c_ 1-co UIOk <br /> . BUILDING PERMIT APPLICATION <br /> Existing Use of Building: kUCO ,OIDY P-CA/Act tZ SttO•P Contract Price of Work:$ `ate Z4 000 <br /> Proposed Use of Building: AUt'0 tp()Ip`>' ik5pAtSCOP Heat Source: ❑Gas DElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: -ECommercial El Industrial <br /> Type of Project: ❑New RAddition ❑Remodel ❑Repair ❑T.I. OSign OSprinkler ODemolition OChange of Use <br /> DESCRIPTION OF WORK: :. ; , • ` :�r <br /> - IFP_ .' UTiktN Pc,t,D6. Pef-Itt t 1S :O fz C4-3 10CI3 - Pew. <br /> Ac O R-Y suRsoctorLes JAN® sOk Abort!O APvt✓ Lfct J D sc P i IJ G. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ACC 'S' d?..-‘1 ST ' 3 2A6 E <br /> MECHANICAL PERMIT'APPLICATION :i PLUMBING:'PERMIT APPLICATION <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 /> NC—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 /> SPRINKLER/'SUPPRESSION S'YSTEIIih <br /> kt' Number 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 be.re bein authorized under any circumstance.I am the owner,or I am authorized by the owner of this properly to perform the work for which application is made, <br /> and I comply wi/'he to Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 2/59/1/1 PERMIT# )15pro® AL10/12/z015) V,llo•wylAut orized Agent Signature (Revised <br />