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1011°111111
<br /> PERMIT APPLICATION
<br /> BUILDING I MECHANICAL!PLUMBING i SIGN I SPRINKLER / DEMOLITION
<br /> *4.4VN*1 'VW7.1 ' CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET EVERETT,WA 98201
<br /> 425-257.881C P AX 425-257-8857 i(Et evernhengoverettwa gov 1 ,..y‘wr evereliwa octifpereTt.c.
<br /> ,(Stue or Stack Ink Only Please) PROJECT SITE INFORMATION
<br /> PROJECT SITE ADDRESS: (0 7 17 el +Ant or s e,.. ,.PROPERTY TAX#: #00 9 )o3 0 0,0eca, coo
<br /> '
<br /> LEGAL ter 11,Y.R,,,,,,i,ntIOC.;t0n Short Platisub,:t....sior Lot No kattach-,.I)Oy of or ,,..,,p•i; ,ripton)
<br /> CONTACT INFORMATION
<br /> OWNER NAME riA it.A.Nritr„-x-t,„„ 1.4 4,, :"teA. TENANT NAME Of Commercial):
<br /> OWNER MAILING ADDRESS: enter: I.0 d'i 1 1 c I 1,--k. V)c rre
<br /> coy r:::'IC-vv./4-4- ulATA. i--1./0~ Po lt,770,3'
<br /> OWNtlifttRONE: 4-tt5.* 7 t !° lowNER EMAIL: ..--
<br /> :CDORADTOR NANIt" NWBATHWORKS, LLC
<br /> CONTRACTOR ADORES*, 18821,4,1TH AVE NE
<br /> erry ARLINGTON . , WA ,,,, 98223
<br /> 1:00111‘4,(cTOR PHONE: 425418-9545 &jot adkctioa tiMifiC NVVBATHVVORKSg,GMAIL.COM
<br /> VONTRACTOR LICENSE#R5011iR .C):.',- VAISAT BL855P A Ci TY OF EVERETT BUSINESS LICENSE etREQUIREO _57184
<br /> .._.........
<br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME CONTACT PHONE: C-125-- 3 (-:;?7- c z g 0
<br /> Ill i oN"C-1-C,,„„„,• ei-V-1 CONTACT EMAIL:
<br /> ' '','r•-"'- BUILDING PERMIT APPLICATION f
<br /> Use of Boit'i .., Contract Price of Work:$ " 1130,00
<br /> ProOeSed Use of Bultdirl*' AirafttittirCe: t:-.1Sas Ce,,
<br /> t:Tiviii; 17.4,-.;::i: ' .‘q-t,,,,,.,-'.'7"--,• -.,, ,,c',.t mastamoy4 of Units: '-1-''''''-' Mr7rii-.;',•'•,-:;i'',.'i"::::',"',; ChoKkietriet
<br /> "Type o"Protect. ONew 0Aciclition ORerrodel ORerair OT I aSirn LiSprinkier ODemoiltion DCha *0 of Use
<br /> 'DESCRIPTION OF WORK:
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<br /> 'ASSOCIATED BUILDING PERMIT#(f applicable) i
<br /> , .., ..,... ...
<br /> MECHANICAL PERMIT APPLICATION 144,4004$41YS;,. -IL' , ,::.,:',.:,.::',1 '3" il ,
<br /> ype of Protect New Acian Alteration Repair Type of Project _New Atkin Alteration Repair
<br /> , .
<br /> #of *of List of Fixtures #of *of
<br /> List of Fixtures Last of Fixtures List of Fixtures
<br /> Fixtures Fixtures FtrItires. Fixtures
<br /> Heat Pump 704#01 Backflow Preventer(Inslds Bing)
<br /> .
<br /> itcad Air Systems Unit Heater Bathtub Urinal
<br /> d... Ite,:,:', .
<br /> Boiler . .
<br /> Lavatory(Wash Basin) Drinking Fountain
<br /> Refrigeration Shower Floor Drain
<br /> ' o:igitapiaita - Grease Trap Wood Stove Kitchen Sink&Disposal ,
<br /> .
<br /> Ran9e Ducting 'Dishwasher Roof Drains
<br /> Clothes Dryer tieittil* ' Other' Clothes Washer Medical Gas
<br /> Range Hood *I4fitit*li1ii: ..
<br /> Other
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<br /> Exhaust Fan Sink i Service/Bar/Mop/etc I Other:
<br /> SPR r ' '''• IsuopRestooN sysTem
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<br /> OhemmetcrAtatet No,of Heads
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