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IVIIIIIIII"IllppPERMIT APPLICATION II BUILDINGALCHANICAL/PLUMBING/SIGN /4MINKLER/ DEMOLITION *iiiwit CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) f PROJECT SITE;INFORMATION PROJECT SITE ADDRESS: SOS Lied- &S is v42 ki PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) t CONTACT INFORMATION OWNER NAME: RJ;ble fJG j5'f' Ch14r61 TENANT BUSINESS NAME(Commercial): SAS e OWNER MAILING ADDRESS: STREET gT5 1J1e5k 6.,5,',0 i(4Q CITY r�1/‹.r`a't-/ STATE 1"14 ZIP g i o 1u OWNER PHONE: 01 25) g 7.0 2Z72_ OWNER EMAIL: CONTRACTOR NAME: RSelPr P164-,ji. a- II�gl-i .1 CONTRACTOR ADDRESS: STREET G 6 o 2 2-01-1" i- 51") t r2 CITY r1/11:21,1•14 'Ake_ L �r1GI,4 STATE TZIP v0 LI 3 CONTRACTOR PHONE: (20(0) 3 37 -21`I 1 nCONTRACTOR EMAIL: 5 e 5 tue-4-,M Ai2010 yw,e.„ I, cow. CONTRACTOR LICENSE#(REQUIRED): 1"} 5 6( PG )3 1 h 1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 514125 PRIMARY CONTACT: 0 OWNER JaCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: / CONTACT PHONE: C2-06.) Z /o C2-06.) � — 1353 3-e_4:( Gftc.i(lot,t.Se CONTACT EMAIL: ✓h 4,r 4- €, 1 o -0,4,i�, c-o, BUILDING INFORMATION Existing Use of Building: Cdu[c., ov‘ !7u,.)), Contract Price of Work:$� "i0v vo Proposed Use of Building: $G,...le Heat Source: ❑Gas NElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: F Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition NRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 41) G. DvtG'f I e55 L e.6-1--i nS /camel; .,,) s ys4, 4 ,k„ 1); ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer .5 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads 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 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 Building Official before being authorized under any circumstance.I am the owner,or l am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 44 , ,/--,„1>--------- I-7- 19 PER #R0[....0 2'1 Owner/A tIhorized Agent Signature Date (Revised 1 /10/2018)