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PE o'MIT APPLICATIOI' <br /> BUIL B ING I MECHANICAL I PLUM:ING I SIGN /SPRINKLER/ DEMOLITION <br /> Noi <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 Slack Ink Snly Please) *JECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 300 S W C.-G, .'."o kat PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONT•CT INFORMATI•N <br /> OWNER NAME: © r�4l� pf ejw `�' TENANT NAME(If Commercial): }�Qeill £o??/; 7' <br /> OWNER MAILING ADDRESS:✓ STREET ® l !'�� Ji <br /> CITY STATE ZIP <br /> OWNER PHONE: r OWNER EMAIL: <br /> CONTRACTOR NAME: a` KK dCv'i1 pl TOC--- <br /> CONTRACTOR ADDRESS: STREET 1 g$o 2- Gj $Q 'N /¢µc. Q J <br /> CITY yZ'�- STATE 1/1 d 4, ZIP C/(��1v ^�/�p <br /> /�/ <br /> CONTRACTOR PHONE: "l 2 ri T-747 - F7V-- CONTRACTOR EMAIL: C�`rbe V Vyynm -L0y,7 ,rte <br /> CONTRACTOR LICENSE#(REQUIRED): ./-1 Upon/// 1 bl1(6'l.t'1' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):0114—P -5---- <br /> PRIMARYCONTACT: 0 OWNER cpC, ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: C-1 f -75 7-- . 3 c <br /> .1! i/Qc/t CONTACT EMAIL: et. 7j0,44 z,,,,,i ed,,LO,.✓f <br /> BUILDING PERMIT APPLICATION /� <br /> Existing Use of Building: Contract Price of Work:$ Lv' "`�/ p® <br /> Proposed Use of Building: Heat Source: @Gas ❑Electric ❑Other <br /> Building Type: @SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: @Commercial ❑Industrial <br /> Type of Project: ONew OAddition @Remodel @Repair DTI. OSign @Sprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: p9�,fj� t,,, `�� 11.2 1l� )14; 141117 t20, -703, 2OSd4, 70c,9 2/c 2-110 <br /> i. ` ?r <br /> ASSOCIATED BUILDING PERMIT#(if applicable): pl V eedJietc)Re_SS(A-R____W-e-dtC4-Jr7 7 Vit <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 /> NC—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 I l Other: f.e1 /w QL,/- h< <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water N No.of Heads <br /> 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 <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 authorize.under any circumstance.I am the owner,ori am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply w"h the State Contr.,ors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 1 ,3609 PT5( 05- Dl, <br /> •,'ner/Authorized Agent Signature ate (Revised 9/23/2016) <br />