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PERMIT APPLICATION. <br /> 0014 <br /> BUILDIN -IIECHANICAL I PLUMBING/SIGNZINKLER 1 DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2_7 <br /> �- '2-7-'1 PROPERTY TAX#: Z go S-7700103 20V <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: EVEeerr 1' (�l)y^I } TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET `�(O 7 C �j <br /> m' <br /> Co 1 I�'- g - �+ <br /> cveE^'Gpeste r W i STATE ZIP 9' ?C)1 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: -T13 N <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: grOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (--f•2..j----=i2i 1"3 '` s � ©ply <br /> 0-r,S)5 \ -c____ ►CC,. CONTACT EMAIL: ,t- y�C�f, k Q__ e.,i i , 6-01 . <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: IS,t3-r4-M }s Contract Price of Work:$ 10 1i- • <br /> — <br /> Proposed Use of Building: Sfj-wt€ Heat Source: ❑Gas ❑Electric CI Other <br /> Building Type: ❑SFR-Detached @SFR-Attached CDuplex QMulti-Family-#of Units: Li CI Commercial @industrial <br /> Type of Project: CI New DAddition CI Remodel CI Repair OT.I. ❑Sign CI Sprinkler @Demolition @Change of Use <br /> DESCRIPTION OF WORK: <br /> N A0\ -S kt-o-4 - -Lar isF. T"--'"T" ;rte-, <br /> ASSOCIATED BUILDING PERMIT#(if applicable):7311 O'3 0 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New— Addn Alteration _Repair Type of Project: _New _Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater s Bathtub Urinal <br /> Gas Piping Boiler 9 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 /> t Range Hood Water Heater Other: <br /> filt Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water 9 No.of Heads <br /> ACKNOWLEDGEMENT:t 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 writing from the <br /> Building Official before being authorized under any circumstance.I am the owner,ort am authorized by the owner of this properly to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> � S �� PERMIT# (.1o( - Dl `7 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/6) <br />