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PERMIT APPLICATION <br /> BUILDING/MECHANICAL 1 PLUMBING I SIGN I SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8310 1 FAX 425-257-3857 I tE)evereltepsgeVerettviLgov 1 www.everettwa.govfpermits <br /> (Glut __ lack ink Only Please) PROJECT=SIi <br /> EINF Mtilfi -i S }{ Yf `T'..: <br /> PROJECT SITE ADDRESS: 4 2„l Li ' 1 k• h <br /> jW`{/'� PROPERTY TAX if: <br /> LEGAL for new cnnst action: Short Plat/,ubdtai„t, CCtiti�l <br /> ' ” "" Lot No.. ;attach copy of long legal description) <br /> CONTACT,tNFO MAT'IDN <br /> OWNER NAME <br /> TENANT NAME(1f Commercial): <br /> OWNER MAILING ADDRESS: a Rs jl { <br /> r ,.r t EE <br /> crY of Acot <br /> } i <br /> OWNER PHONE: <br /> OWNER EMAIL; <br /> CONTRACTOR NAME: ,. an 1nc-. <br /> CONTRACTOR ADD RESS: (� � � <br /> STREET 1`C <br /> .. p� <br /> CITY "L..('-VV s1ArE ILA) ... ref= "L D l✓ <br /> CONTRACTOR PHONE: LZ�~�- Z'3a. o 5a 'CONTRACTOR EMAIL° <br /> __ �N�a�AcTBi�— CM—�{f�Qt�ts�� )._ ._ e.-' �.It��"?L� ��Yl�'#.C�_�L°`�`V1 °��f`�` <br /> ��y,�t� <br /> �^+r 1 r'1�:#-t� "! `�°R-4---CIfiY�F`EYE1$i~7'I'BUSINESS tfCENSE73(REgUiREDj: C}679 <br /> PRIMARY CONTACT: CI OWNER tYCONTRvACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: ) <br /> ^,^c^ CONTACT PHONE: 2S 25 CI CD <br /> �i�'J CONTACT EMAIL: <br /> ..,.i,es L2 • C�1 Elg Co. <br /> - , 'BLt1LDtNG`PERMtr t*i°rit N wTr- "r <br /> l.. stftl Use of Building; <br /> Contract Price of Work:$ 41 <br /> Proposed Use of Building <br /> Heat Source: OGas �. <br /> Building Type: :ta:FR_Oetavhed ❑SFFi Attached C❑L7up!e ❑MIti-Farnit #of Units L=` ■. er <br /> til. <br /> Type of Prope:f; ❑New A7ditian pR mods! ❑ _ _ QCommercial ❑Industrial <br /> DESCRIPTION OF WORK: R err DT I. CJSi°n Q.Sar' L7Qemalifion Qha sus of Use <br /> V �l.e..ikA..t.aS. t it a(�-1-�A/�}ui\A_.� <br /> ASSOCIATED BUILDING PERMIT# if applicable): r _`-f",1 ` <br /> "MECHANICAL'>PEIRMIT'AWtPl.1GATlC)N-',, .`,; <br /> Type of Project: _New t,,�"1.lJMEliI)TV�{�'PEjTfVI[1'�APP.LCA"t'It7iiV <br /> j ,_,_, Addn Alteration Repair <br /> #of Type of Project: New Addn Alteration Repair <br /> ° — - [*3�Z .%Xlttrres .. <br /> ti of <br /> FixfUr2s —lista Fdxtu�es-_._ f Ffxt�i<es #of <br /> A1C-Air Handling Units Fixtures Fixtures List-of Fixtures--....--.._..._ <br /> - <br /> MillForced Alr Systems Haat PUMP Toilet <br /> `" Bathtub Preventer(Inside Bldg) _. <br /> �� Boiler MINNILavatory(Wash Basin DUrinai <br /> Refrigeration Shower rinklrt•Fountain <br /> Wood Stove Floor Drain <br /> Clothes 0 Oueting Kifchen Sink&Oiap<ssal Grease Trap <br /> r r Hookups Dishwasher <br /> Roof Drains <br /> Clot a Haad1Other. <br /> MN Clothes Washer <br /> ��ITli e Hood <br /> IMINIIMme �Water Heater Other: Gas <br /> Sink Service/Bar/Moo/etc. Other: , <br /> SPRINKLER/SUPPRESSION SYSTEM . • <br /> MIChemical or Water <br /> No.cf Heads UM <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct Work done pursuant to this permit must <br /> law.Thegranting <br /> authorizes <br /> Building Official before being authorized underany circumstance.it l athe owner,or I am authorized by the owner of this propert to err <br /> approved work and no deviations therefrom.Deviations must flat be authorized In writing comply with <br /> current federal,state,and local <br /> and f comply with the Slate Contractors Law 18.27 RCW and 296.20124 WAC. <br /> tromtha <br /> y A or <br /> m the work for which application is made, <br /> City of Everett OfNcfal Use Qnrit <br /> ow,ertrtiutticrfzed Age SignaturA NVL ( D...._�� <br /> Cale (fiev(sed 2G�76J <br />