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PERMIT APPLICATION
<br /> "--.... _."...4 BUILDING I MECHANICAL I PLUMBING /SIGN/SPRINKLER ! DEMOLITION
<br /> 4CITY OF EVERETT PERMIT SERVICES
<br /> 114, V-
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)4252571( 425-257-n857 j(E)everettens@everettwa„govl www eii,",
<br /> Slue or Black Ink Only Please) PROJECT SITE INFORMATION
<br /> PROJECT SITE ADDRESS: .01C)I9 ki i-Ct.,/C-Veni`T ra 04e- IPROPERTY TAX#: 4,
<br /> LEGAL for new construction Short Plat/subdivision Lot No. (attach copy of long legal deschnition)
<br /> CONTACT INFORMATION
<br /> OWNER NAME: a i ‘ TENANT NAME(If Commercial):
<br /> , , ,..
<br /> OWNER MAILING ADDRESS: .$,.-i<rr::- '70 C:). I./ LCL.", CAre-Aett1T 4 Li"ge.i.
<br /> 9 g'2.0 3"
<br /> W$#' O$ : 9'751 3S3 - LI -e 3 F
<br /> ..„ OWNER EMAIL: 4............._
<br /> CONTRACTOR NAME. NWBATHWORKS, LLC
<br /> •
<br /> CONtilltAiCiti.;.sA olsRES'i 18823,,IXTH AVE NE
<br /> CM, ARLINGTON sTATE WA zip 98223
<br /> CONTRACTOR PHONE: 425-418-9545 ),:';-:,„;.'..!,':.'.. ''•','7lk. . :': ...,', NWBATHWORKS@GMAIL.COM
<br /> CONTRACTOR LICENSE*REWIRED): NWBATBL855PA CITY OF EVERETT BUSINESS LICENSE AI(REQUIRED): 57184
<br /> PRIMARY CONTACT: 5if OWNER 0 CONTRACTOR 0 OTHER(Please Specify) ..„._
<br /> CONTACT NAME: CONTACT PHONE: 44 TS' -3 5-1. -
<br /> '
<br /> 1-i.) k k ‘A Cr; \\4 CONTACT EMAIL:
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<br /> BUILDING PERMIT APPLI#L*EGN
<br /> EXisting Use Of IStilk#,ii*!' Contract Price of Work:$ 'S1100-00
<br /> ....
<br /> Proposed Use of Building: i4'". "'",;.•',',,"':%.''' ;ff`'/''','''' ', 7, i^ '.,;, •IN i ":'',4'1W'2r,:',*::•4i4lOt'n..,"::
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<br /> Type of Project: I:New 0Addition °Remodel Medan'. OT I DSign OSprink ler ODemolition OChange of Use
<br /> DESCRIPTION OF WORK:
<br /> r' e--te\ac-c„ 35 G-40-A C t C C'fi %<- TrA.0- tt„
<br /> ASSOCIATED BUILDING PERMIT#Of applIcable)-
<br /> i_tvlEstaatilel At PERMIT APPLICATION , PLANIEBRIESIPEIDEFf0SWE:i
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<br /> Typo ot Project: New A ado Alteration Repair Type of Project NewAddy Afterslion Aoswair
<br /> 4 of_ #Of ' f
<br /> #of #of
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<br /> List of Fixtures ixtureS List of Arxure$tLest of Fi
<br /> axturxtures Ostofftelts
<br /> es Rotaries Fixtures
<br /> NC-,,..Air Handling:0W Heat Pump
<br /> ...o.ti,.. i Backflow Preventer(Inside Bids)
<br /> Forced Air Systems Unit Heater Bathtub ' Urinal
<br /> CAPI.r,019,11 Boder-W ..,Lahvoawtoeryr (Wash Basin) _ Drinking Fountain
<br /> Shower ater Heater: Refrigeration Floor Drain
<br /> -. ' ..
<br /> 4 .......„ •• , - __
<br /> Os FireittlaMI Wood Stove „ Kitchen Sink&Disposal Grease Trap
<br /> Ducting Dishwasher Roof Drains
<br /> -'-'141*,' '1.* I Other ,
<br /> Clothes Washer Medical Gas
<br /> Range Hood
<br /> Other
<br /> Exhaust Fan . .
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<br /> Sink i,Service/Bar/Mop/etc,) Other.
<br /> s R iyppRigs
<br /> 1..,. ,,„,,,,,,,,,,„„jctier**iiirnt 1 No.of I-feeds
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<br /> PERMIT#
<br /> '!•••1 1 ''''-1
<br /> fri.R0 -02-9
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