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0 #2668 P. 001/002 <br /> 9/27/2017 09:05 <br /> II II,, PERMIT APPLICATI� <br /> ��''� BUILDIN /MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> '^ .a -- CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> F, ` ';i" r ','!' : 1i: (P)425-257-8810 I FAX 425-257-8sc 7 veretteps®everettwa.gov I ttwa.gov/ er i s <br /> •... www ev <br /> . .. ..:...,......,., . .. .IECT:.SITE'IINIrOR <br /> PROJECT SITE AD �� ��•� t ' <br /> OC 7 f6#/(47 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivisfon <br /> - <br /> Lot No.� (attach copy of long legal description)• ' <br /> . ;•';,.:•:i'::::.. . .0-: : NTAt=,T INF:ORMAT omme c <br /> OWNER NAME: �. TENANT NAME(If C ria!): <br /> • OWNER MAILING ADDRESS: sTaser 01 SA-164,7i4 . LACK -- • <br /> CITYSTATS Z!P !JO <br /> OWNER PHONE: 9,2 2 OWNER EMAIL: • <br /> CONTRACTOR NAME: ,_g./ A ( /C /'Y/ ` — <br /> ,CONTRACTOR ADDRESS: STREET r y i i Ar A' <br /> cirY ! / ,. . r _ STATE ztP 7 J <br /> CONTRACTOR PHONE: vg ,?..(Tr 1/0 / CONTRACTOR EMAiL: <br /> CONTRACTOR LICENSE#(REQUIR a_J.L_f C I< Z O1TY OF EVERETTBUSINESS I.ICENSI;#(REQUIRE°); /�� <br /> PRIMARY CONTACT: °OWNER LI CONTRACTOR 2rOTHER(Please Specify) _ . - <br /> CONTACT NAME: CONTACT PHONE: 7 2" .231 2 2, <br /> IP 4 66 i_)U i L II OS CONTACT EMAIL: <br /> :: . M::arn PEr:M>t °Aallai(oN :::! <br /> Existing Use of Building: _ Contract Price of Work:$ C Q <br /> Proposed Use of Buildin : fg Heat Source: °Gas lectric LlOther <br /> Building Type: OSFR-Oefached 1:18FR-Attached IaDupiex OMuiti-Famlie0 of Units: DCommerciai ❑Industrial • <br /> e of Proect: °New °Addition °Remodel DRe air DT.I. Els] n 118 rinkler °Demolition ©Chan a of Use <br /> DESCRIPTION OF WORK: <br /> RipUc Puivip <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> . <br /> • <br /> . <br /> •:`::=';MECHANICAL::.PERMIT APPL ICATiCIRI '.•:.::: • :. ' .. : ::... ',P :U'MBtNG•PERMIT APPLICATION ' <br /> Type of Project: _New_ Addn LitaratlonRepair_ xtures Type of Project: New �►ddn �,}literation _Repair <br /> #of List of Fixtures ' #of List of Fixtures #of gist of Fixtures <br /> Fixtures t=/xt� _List_of Fit'ixtGres Fixtures <br /> A/C--Air Handling Units I Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air-S stems 8 Unit i•teater 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 Heaters <br /> Other: <br /> Exhaust Fan . SinkLServlce/Bar/Mop/etc.) Other: <br /> - <br /> k - � <br /> ._: :SPRIINKl ER I SUPPRESSION SYSTEM <br /> :<:.::.'� <br /> ' <br /> [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 witting from the <br /> Building Official before bein,authorized under any circumstance.lam the owner,or f am authorized by the owner of this properly to perform the work for which application is made, <br /> and I comply with th:Stat, ontractors Law 18.V RCW and 296,2o0A wAa <br /> City of Everett Official use Only <br /> /f r rPENI <br /> -� i .� / 9 - ate <br /> Air <br /> Owner/A oil�' Agent -Ign Jr' Date (Revised 90/92/2095) <br />