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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER I DEMOLITION <br /> ell441:01<"--/-7411°. <br /> CITY OF EVERETT PERMIT SERVICES <br /> 33200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 € FAX 425-2574857 I(E)everetteps@everettwa.gov[ www.everettwa.govfpermits <br /> tinuto or Slack Ink Only Please' _ PROJE Td.S TE , O RMMMATION _. _.. .... _... <br /> PROJECT SITE ADDRESS: 806" Otv yti .fiv Evert ` "r:203 PROPERTY TAX#: <br /> 'LEGAL for new construction'. Short Piat subdivision .,- Lot No. (attach copy of long legal description) <br /> ' - .: ,' _ O*CIN- M T N <br /> OWNER NAME: ! A. a. sTENANT BUSINESS NAME(Commercial): <br /> y, <br /> OWNER MAILING ADDRESS: STREET t, 4+1i 0kt t "} 1 , <br /> city E v C' sTarE L}Pk. zip }$'2 3 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Muskt" <br /> CONTRACTOR ADDRESS: STREET 4322.. SO oft*, <br /> cn t ,I; } 1 •I <br /> CONTRACTOR PHONE: WO"` 578 --79 c 2 CONTRACTOR EMAIL: OlFria qM'`e r" +t v-e -C r <br /> CONTRACTOR LICENSE#(REQUIRED): mourm64,s3 7146 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)S 7 J l <br /> PRIMARY CONTACT: 0 OWNER 'CONTRACTOR 0 OTHER(Please Specify) w <br /> CONTACT NAME: orncxV` f CONTACT PHONE: q.... 576-7418 "" <br /> CONTACT EMAIL: b .' .l`'s'P <br /> riek <br /> ' "44104#03 IN ate-_ _ ' <br /> Existing Use of Building; <br /> --,---`""'` Contract Price of Work:$ _ ry 4#.40/ <br /> Proposed Use ofBilding: .- '" "- Heat Source: DOas °Electr€c 00ther <br /> BUILDING Building: <br /> RDTI. <br /> a Units:...._ <br /> atal <br /> a �Structure <br /> Type of Project: KNew LjA itionORenodel . epair DTI ISignDSprinkler CemlitlnDChane o Use <br /> DESCRIPTION OF WORK: <br /> iepttkCe.fieri+- OF kirke t &00.4reir Seca.. ti.oe . t strkcX, 2 irw,AN <br /> PVC. t tie . e d "Cr r,, 2.:y-- t,ai neo• )"Troy 44,42, vlRt ce— 4t C " .„3( space_ <br /> ASSOCIATED BUILDING PERMIT#(if applicable): MAftifix2. ZOO b>0..Si C0.0113Veied CIS C e c t 2-2-c1-1 <br /> MECHANICAL POROTT APPLICATION' PLUNIOINWPERMIT APPLICATION <br /> FixtureList of Fixtures Future Fixture I Ffxturo <br /> Count count List of Fixtures Last of Fixtures List of Fixtures <br /> Count Count <br /> A/C--Air Handling Units Gas Piping Sacktlow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-cornp:prep,fioor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residenliat(kitrhen,bath,bar) <br /> -Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilator Floor Drain Toilet <br /> Exhaust Hood(Type I) (Nat Heat/AC system) Hose Bibb y <br /> Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil / Water Service(behind meter) <br /> Forced Air SystemsOther: d Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roost Drains Water Heater <br /> SPR4',W%E.AI SU ntesst N$alt`$_, Sewage Ejector or Sump Pump Other: <br /> Water uuppression System No,of Heads ` <br /> Chemical Suppression System ,No.of Heads <br /> ACKNOWLEDGEMENT'I have reviewed this application and confirm the information contained heroin 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 circa mstanee.I am the owner,or t am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 29E200A WAC. <br /> City of Everett Use Only <br /> 47 40 <br /> 42 - PERMIT IT tt?1 12—0 <br /> '' .; ., <br /> I� <br /> thpriz tin Date <br /> ' tevised 110r01t <br />