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10/30/2017 08:41 #2815 P. 001/004 <br /> eill!!-- PERMIT APPLICATION - <br /> BUILDING I MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8657 1(E)everetteps©everettwa.gov i www.everettwa.gov/permits <br /> .Sl lo••ar.':II11aackInk•Onl :Flom .. .; �PRGJECT SITEINP0RMATION:'.- . ••: .. • . <br /> PROJECT SITE ADDRESS'A$ / J , • 1 • PROPERTY TAX#: ,__r._ <br /> LEGAL for new construction: Short Plat/subdivision Lot No, __ (attach copy of long legal description) <br /> .. CqN'1'q,C'1'.IMi"ORIIICI#'.If'ION ..' :.' -;..;.'. <br /> Air fj 61L_AiA TENANT NAME(If Commercial): <br /> OWNER NAME; �ft�dM f Air f 7� <br /> OWNER MAILING ADDRESS: stnEErfit- 1 A L <br /> cin V <br /> F� STA'iE ZIP `2 G <br /> �j <br /> OWNER PHONE: A _ 3 OWNER EMAIL: <br /> p <br /> CONTRACTOR NAME /4�1n c� <br /> T–CS � . Ire <br /> CONTRACTOR ADDRESS: STREET • ( l 0 rr . m Aur --STATE A I/ ZIP <br /> CONTRACTOR PHONE: 2 2A CONTRACTOR EMAIL: •,— <br /> CONTRACTOR LICENSE*REQUIRED): 1L. Iv 1.l/'al-/porrY OF EVERETT BUSINESS LICENSE.0(REOUIRED):0 3 <br /> PRIMARY CONTACT: D OWNER ❑CONTRACTOR QGTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE; 2_,¶ 27J -c <br /> ccx4ttet.ter t5 EIL, CONTACT EMAIL: <br /> 1 0 ,....... 01:0. l RMIT:APPI.ICATION :.. . <br /> Existing Use of Building: G S _ Contract Price of Work:$ <br /> Pro�osed Use of Building L 11Gr Heat Source: .was 1:1Electrio ❑Other <br /> Building Type: OSFR-Detached DSFR Attached IJDuplex CIMulti-Farnil -#of Units: ClCommercial ❑industrial <br /> Type of Project: f New iJAddition IJRemodel ❑Repair DT.I. ❑Sign ❑Sprinkler ❑Demolition DChanne of Use <br /> DESCRIPTION OF WORK: <br /> f2ZP LA-e 6. J F b 0--A1 /1–C <br /> ASSOCIATED BUILDING PERMIT it if a••linable: <br /> ',•:': : '••NIRCHAN.IC�':P!SRINIT•APPLICATtON :. ..': P1AIMBINQ PS.RMIT`APPI:ICATIOP4:• . . . :• • <br /> Type of Project: ___New _ Addn _Alteration _Repair Type of Project: ,New ,Addn Alteration ,_Repair <br /> #o! List of Ftwres i *o! List of Fixtures of List Of Fixtures #01 List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtum <br /> NC—Air Handling Units Heat Pump Toilet Backflow Preeventer Slnside 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 /> Ran a Hood - Water Heater Other: <br /> Exhaust Fan - Sink(Service/Bar/Mop/etc-) Other: <br /> '',$PRI:N1 11:R 1SUPPRESSION-.S' '&TEM •:':�'; <br /> Chemical or Water I INo.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is tram and correct.Walk done pursuant to this permit must comply with <br /> current federal,state,and bona/law, The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must fest be authorized in writing from the <br /> Building Official belbre being 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 l comply with the State Contractors Law 78.27 RCW and 29P 200A WRC <br /> city of Everett Official Use Only <br /> j . /0 %0V 7 PERMiT# <br /> .e - 0 e)4 .3 I <br /> Owned• ''orlssd Agent Signature Date (lievised 9/2312016) <br />