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PERMIT APPLICATIO ■. <br /> ��^�''� BUILDI MECHANICAL I PLUMBING/SIGI MI.1RINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 -- <br /> (P) <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everefteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: (d)-7 ,% eveye4f y ,I ()oat,/ # 1 'PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision y Lot No. (attach copy of long legal des "on) 1 <br /> CONTACT INFORMATION <br /> OWNER NAME: N W 4,1'1 me -Fro per-hes, Inc._TENANT NAME(If Commercial): fi A CA <br /> OWNER MAILING ADDRESS: smeer f�jI I O N( -7'Ill( 7PL /� /� <br /> CITY , )UI <br /> ooai R� STATE WA II� <br /> ZIP o 7P.._ <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: PJ'PJ£T 5& y) Se-Vice 3 <br /> , _ i' <br /> CONTRACTOR ADDRESS: STREET /(002 . di3ok e\� e e-M iy 17-,23`1 <br /> ,1 Q� <br /> CnY n)t ft (4 JL STATE iiv,A- ZIP `/1 Go <br /> CONTRACTOR PHONE: `f 26• )50, a(0(J CONTRACTOR EMAIL: hb{-S 1 q f13(" Wl S C'.CO WI <br /> CONTRACTOR LICENSE#(REQUIRED): PJR1Si 5AK 9 cio-PQ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 5 5 1 oil <br /> PRIMARY CONTACT: 0 OWNER XCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: RanV. CONTACT PHONE: 1+25. 330.3 /00 <br /> CONTACT EMAIL: bbtS 19\5 S n <br /> BUILDING PERMIT APPLICATION J <br /> Existing Use of Building: Cbh1fl C)Cl.1 Contract Price of Work:$ 1, 9 19 <br /> Proposed Use of Building: N/Pt Heat Source: ❑Gas lectric Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: nmercial ❑Industrial <br /> Type of Project: ONew DAddition ORemodel ORepair ❑T.1. I, Sign OSprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> f nZiCW ( 1 ) 1-50 char Ie 1A-61( Std r) <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION 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(ServicelBar/Mopletc.) Other <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Chemical or Water 1 No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confine 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.I am the owner,ort am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> i / PER <br /> Own-egp <br /> Agent •ignatur• Date (Revised 9/23/2096) <br />