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BUIL 1 MECHANIC�L4LU B1NG 1 SPRINKLER 1 DEMOLI ION <br /> �� CI-T GGFFE- ERTT SEI .—S <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 j FAX 425-257-8857 1(E)everetteps@everettwa.gov j www.everettwa.gov/permits <br /> (t>sa ; »,(:1 4 )10 .«"6111iy 1014. 6)41-,4-6, <br /> . 4& .®, .0.1r il.t.1 ) . OR> l a if*:k9. :- : ..: <br /> Y3 PROJECT SITE ADDRESS: 2911 co 4T-,. -6, 9. (&e tt t A q6 Oi PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivisio>��IT�lOLA Lot No. (attach copy of long legal description) <br /> l. <br /> ::.-_..: . i .. ::. . _;... .-.CONT C T>tNRM ;�<>i <br /> FO � O1�1 . <br /> le OWNER NAME: j }Al i 1A)&l t,4) TENANT NAME(If Commercial): PAW- AL() (RDA° YAM ie__‘)e. <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: (- OWNER EMAIL: <br /> 'k CONTRACTOR NAME:... I,C.viet tirf- .. ....5LtzoLi IVtt'<.. ..(�V4v\ .. . .6v, ) q � <br /> g.71 . ..M. <br /> CONTRACTOR ADDRESS: STREET 2.1 i to . 4,4e 4f , `"!,b 2.1 10-GI/(T-e•cei.--.nitiwip4 1 L I Ujit <br /> Cny cl eile h STATE \AJ A ZIP °1 2O 1 <br /> CONTRACTOR PHONE: a j , Z3c1.o l 0(K CONTRACTOR EMAIL: ilytu)•4u tylvi + (,v. cowl <br /> CONTRACTOR LICENSE#(REQUIRED): CiTY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> , _ <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR ❑OTHER(Please Specify) ~~�H~.-�,.-.m...�....w.,�..,...�..�._.._..u�.�w. ...�.�.,.�y.,.,�....�....,..--�.� ,n�� . <br /> .r <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> .- <br /> <:. .;'• : •. - •-. , -• -_ . - .. --,...161-110114P.:- PERIViI'I'APPLI �GATION -' - - '- - <br /> Existing Use of Building: Contract Price of Work:$ <br /> Proposed Use of Building: Heat Source: ❑Gas DElectric 0 Other <br /> Building Type: ❑SFR-Detached ❑SFR Attached ❑Duplex ❑Multi-Family#of Units: ❑Commercial ❑industrial <br /> Type of Project DNew ❑ dditio ❑Rem del ❑ epair DTA. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use - <br /> ei DESCR.PTION OF ITT) <br /> WORvs 1 <br /> Co+/r 115, f id--` 0" S-11(114, Plaivivips66,10-1101 <br /> � <br /> • <br /> ASSOCIATED BUILDING PERMIT#(if applicable): . _ <br /> `'..._:•....M:ECHANICAL:PERM TAPPLiCATION• `` -: PLUMBING`PERMIT:APPLICATiON . , : ' - <br /> Type of Project: New Addn Alteration Repair Type of Project: New Addn Alteration Repair <br /> #°f List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C–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 b 3- Sink(Service/Bar/Mop/etc.) Other: <br /> : 1'-- SPRpN1 .ER/ UP <br /> SPRESSI®4.$.V$ `E•i1j�.. . :..-• <br /> Number of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work clone pursuant to this permit must comply with <br /> current federal,state,and local la -gran in. f a permit only authors rayed work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before bei =uthorized under an circumsta e. m the owner,-orI am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the . -te Con --ra2?...,,r i and 296.200A WAC <br /> �� City of Everett Official Use Only <br /> ' PERMIT# �p 7 <br /> `a I l OP) <br /> Owrie,e.ti. <br /> Agent Signatu e Date (Revised 5/20/016) <br />